Medicine and Health Sciences Commons^™

The Effectiveness Of Integrating Religious/Spirituality Beliefs Into Psychotherapy: An Integrative Review, Justina Anighoro-Okezie

Doctoral Dissertations and Projects

This comprehensive review explores how integrating religious beliefs into psychotherapy impacts mental health outcomes. Following a structured approach guided by Whittemore and Knafl's (Nov 2005) methodology, the review involves a systematic literature search across academic databases, identifying 25 studies with diverse methods. Results indicate significant enhancements in both psychological and spiritual outcomes when religious beliefs are integrated into psychotherapy, compared to no-treatment control conditions. Compared to alternate treatments, adapted psychotherapy demonstrates a small to medium effect. Particularly in an additive design, while there's no significant superiority in psychological outcomes, there is in spiritual outcomes, emphasizing the potential benefits of incorporating …

Ensnared Care: How Restrictive Healthcare Laws Impact Mothers, Mckenzie Richards

School of Public Policy Capstones

Do restrictive healthcare policies impact whether expectant mothers receive adequate prenatal care? Could such policies also affect access to alternative birthing options for delivery? Through a literature review and a two-way fixed effects model using panel data, this study investigates two categories of state-level restrictive healthcare policies: scope of practice laws and certificate of need laws. The literature demonstrates the detriments of scope of practice care on access to care and maternal health. However, the statistical models presented on scope of practice find no relationship between scope of practice laws and adequate prenatal care or alternative birthing options. Though the …

The Effect Of Having A Higher Percentage Of Better-Educated Nurses At A Bsn Prepared Educational Level Or Higher In Any Clinical Setting To Improve Patient Outcomes, Olusegun Michael Nutayi

Doctoral Dissertations and Projects

An understanding of the complexity of today’s healthcare system is important for providing the best evidence-based practice care in any clinical setting. Nursing care is paramount in today’s healthcare setting including nursing education, the nursing skills, knowledge, and productivity that can enhance patient overall care. This scholarly project put forth the effects of having vibrant and productive nursing care that will improve patient outcomes. It focuses on linking nursing education to better patient outcomes in any clinical setting as well as looking into the understanding of nursing staffing, and the work environment associated with patient outcomes. This scholarly project intends …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Scholarly Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Implementing The Phq-9 Tool To As A Standard Of Practice In A Mental Health Setting: A Quality Improvement Project, Gabriella Laferriere

DNP Projects

The objective of this project was to implement the Patient Health Questionaire-9 (PHQ-9) tool as a standardized protocol for depression screening on patients being treated at an outpatient mental health facility in Central Connecticut, where there was no depression screening protocol in place. The clinical question being asked was, is there any correlation between use of the PHQ-9 tool and changes being made to a patient’s depression treatment plan?

Methods: A data collection form was completed by the psychiatric nurse practitioner on each patient who met the following criteria: Depression and/or anxiety was the patient’s primary diagnosis and patient was …

Effects Of A Compassion Fatigue Workshop On Psychiatric Mental Health Nurses, Johnnie Elizabeth Bower Bsn, Mary Johnson Dnp

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Compassion fatigue (CF) is a collection of symptoms associated with exposure to traumas experienced by other people. Nursing is one of the professions that experiences CF from recurrent exposure to patient and family distress and from potential acts of abuse at work. Nurses working in behavioral health are one of the highest at risk for CF. Of newly graduated behavioral health nurses, 17.5% leave the field after one year and 33.5% leave after two. Signs of CF include hopelessness, feelings of inadequacy, anxiety, depression, fatigue, and increased absenteeism. Training in self-care techniques and mindfulness builds nurse resilience and …

The Impact Of Patient And Provider Education On Statin Therapy Initiation And Adherence In Type Ii Diabetics, Jane Harlan Bsn-Rn, Lindsey Jacobsen Bsn-Rn, Emily Easterly Bsn-Rn, Mitch King Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus (T2DM) is a common, chronic disease that increases the risk of coronary artery disease and stroke fourfold, which makes protecting cardiac function a priority. The American Diabetes Association (ADA) and American Heart Association (AHA) recommend the prescription of statins to reduce cardiovascular complications. Unfortunately, provider and patient adherence to this recommendation is poor.This study aimed to determine if shared-decision making and patient follow-up within a 6 month period of being newly diagnosed with T2D has an effect on the initiation rate of statin therapy.

Methods

In this retrospective study we requested data from the University …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

The Experiences Of Staff Nurses Who Remained In Their Permanent Positions During The Covid-19 Pandemic, Huifang Cheng

Seton Hall University Dissertations and Theses (ETDs)

Amidst the persistent shortage of practicing nurses in the nursing profession, exacerbated by the unprecedented challenges of the COVID-19 pandemic, this study investigates the experiences of permanent staff nurses during the pandemic, with a specific focus on the factors influencing their decision to remain in their roles despite the adversities. Employing a phenomenological approach, in-depth interviews were conducted with thirteen permanent staff nurses to explore the intricacies of their experiences. Throughout the pandemic, the participants encountered profound ethical dilemmas. However, their determination to persist was fueled by a sense of professional duty, solidarity within their professional community, and deep camaraderie …

The Role Of Occupational Therapy In The Recognition, Assessment, And Treatment Of Presbyvestibulopathy, Jennifer Hill, Ellen Hudgins, Sharon Leonard

Articles, Abstracts, and Reports

No abstract provided.

Effect Of Certified Diabetes Clinical Education Specialists On Adults With Type 2 Diabetes, Rachel Faller, Tracy Gregory, Michelle Jones, Peyton Barnett, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus affects 13.1% of adults living in Shelby County and over 30 million adults in the United States. This chronic disease creates a higher risk of macrovascular and microvascular complications for this population resulting in poor outcomes if not properly managed. Improving glycemic control can help to improve the quality of life for people living with diabetes and reduce healthcare costs. Currently 20% of funds spent in the United States on healthcare is utilized for diabetic care. Certified Diabetes Care and Education Specialists (CDCES) primarily educate patients about managing their diabetes, including health promotion that can …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Initiating Culturally-Directed Education For Hispanic Adults With Type 2 Diabetes Mellitus, Marie Davis, Jennifer Smith, Mandy Horner

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND:

The U.S. Hispanic population has the highest rate of Type 2 diabetes mellitus (T2DM), which is influenced by socio-economic status and language barriers. Current evidence suggests that the delivery of culturally-directed Diabetes Self-Management Education (DSME) with the use of an interpreter can reduce diabetes-associated complications.

LOCAL PROBLEM:

The project took place at a free clinic in North Carolina. The purposes of this project was to create a culturally-directed DSME bundle for Hispanic adults with the use of a Spanish interpreter to improve understanding of T2DM management.

METHODS:

The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was …

Antibiotic Stewardship In Patients With Viral Upper Respiratory Illness: Improving Quality Measures In Retail Health, Meredith A. Nolan, Robin Harris, Clay Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Millions of people will die from antibiotic-resistant bacterial infections in the next 30 years. Retail health providers are pivotal in this global epidemiological problem.

LOCAL PROBLEM: Setting included 15 retail health clinics operated by Vanderbilt University Medical Center in Middle Tennessee. Project examined provider education, patient engagement, and commitment to antibiotic stewardship, components of the CDC's Core Elements of Outpatient Antibiotic Stewardship framework. Specific aims were that providers would have a significant reduction in the percentage of antibiotics prescribed for viral illness over the study period.

METHODS: Using the Evidence-Based Practice Improvement Model, a Quality Improvement …

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Working Under Pressure: Evidence-Based Risk Assessment And Pressure Injury Prevention In The Pediatric Intensive Care Unit, James A. Hutcheson Iv, Allyson M. Neal

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: The hospital-acquired pressure injury (HAPI) can have physiologic, psychologic, and financial sequelae. Children are at increased risk secondary to immature physiology, developmental differences, and severity of illness. Evidence suggests presence of medical devices exponentiates HAPI risk.

Local Problem: Upward trends in HAPIs revealed nearly 50% are device related in the project setting, an urban Pediatric Intensive Care Unit. The Braden QD Scale was identified as best evidence for HAPI risk assessment. This initiative aimed to observe the ability of the Braden QD Scale as a predictor of HAPI risk as compared to current practice utilizing the Braden Q …

Improving Dementia Symptoms Through Personalized Music, Lindsay Grainger

SC Upstate Research Symposium

Alzheimer's disease and related dementia (ADRD) is a prevalent, costly, and complicated disease. With over 6 million Americans affected and the cost of treatment soaring to over $320 billion dollars annually, there is a growing need for low-cost interventions to treat symptoms. Routinely listening to personalized music selections has been shown to reduce agitation—the most common symptom of Alzheimer’s disease and related dementia. The purpose of this study was to provide a personalized music listening (PML) intervention of thirty minutes to 10 nursing home residents with dementia. Thirty-minute PML sessions occurred multiple times a week over six weeks. The inclusion …

Hgs-3 The Influence Of A Tandem Cycling Program In The Community On Physical And Functional Health, Therapeutic Bonds, And Quality Of Life For Individuals And Care Partners Coping With Parkinson’S Disease, Leila Djerdjour, Jennifer L. Trilk

SC Upstate Research Symposium

Purpose Statement: Several studies have shown that aerobic exercise can have a positive impact on alleviating symptoms experienced by individuals with Parkinson's disease (PD). Despite this evidence, the potential benefits of exercise for both PD patients and their care partners (PD dyad) remain unexplored. This research project investigates the effectiveness, therapeutic collaborations, and physical outcomes of a virtual reality (VR) tandem cycling program specifically designed for PD dyads.

Methods: Following approval from the Prisma Health Institutional Review Board, individuals with PD were identified and screened by clinical neurologists. The pre-testing measures for PD dyads (N=9) included emotional and cognitive status …

Final Scholarly Project: Clinical Guidelines For The Perioperative Management Of Patients With Opioid Use Disorder Requiring Anesthesia, Jessica Kayla Joos

Doctor of Nursing Practice Scholarly Projects

Opioids have highly addictive properties that allow for high levels of misuse. Since the early 1990s, the misuse and deaths rates related to narcotics have steadily risen in the United States. Efforts to identify individuals using opioids prior to surgery have proven difficult. The number of patients misusing opioids and reporting for surgery can only be estimated due to under-reporting related to fear and self-stigma. With 50 million surgeries in the U.S. annually and 3.32 million people misusing opioids monthly, the chances of a patient with Opioid Use Disorder (OUD) presenting for anesthesia are exceptionally high. Moreover, patients who rate …

Police Versus Non-Police Response To 988 Crisis Calls, Miriam A. Maloney-Mattheisen Bsn, Rn, Latrina N. Blakemore Msn, Fnp-Bc, Janelle M. Scullark Msn, Fnp-C, Jacqueline Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The 988 Suicide & Crisis Lifeline is a mental health-specific emergency line that became nationally available in July of 2022. This resource allows callers in crisis to connect with trained mental health professionals. Despite the initiation of this new dispatching service, there is still a significant shortage of trained mental health professionals to respond to these calls when they require emergency intervention. The present scoping review aims to determine whether non-police crisis responses correlate to improved outcomes when compared to police response as evidenced by reduced inpatient admissions, reduced arrests, and decreased presence of intrusive traumatic symptoms following intervention. …

My Mother's Milk For Michigan Infants Data Web-Based Application Focus Group Feedback, Delaney Wesolek, Aurore Shima

23rd Annual A. Paul and Carol C. Schaap Celebration of Undergraduate Research and Creative Activity (2024)

To reach national expert recommendations of 6 months of exclusive human milk for infants, a multifactorial and interdisciplinary approach is needed to increase lactation outcomes. Mother's Milk for Michigan Infants (MMMI), a nurse-led research team, developed MyMMMI Data, a bilingual (Spanish and English) encrypted web-based smartphone application. MyMMMI Data provides targeted enhanced lactation education; tracks participant-recorded feeding, pumping, diaper, and weight logs; and links participants to online resources. This study aimed to assess the visual appeal, usability, and helpfulness of MyMMMI Data to increase lactation duration. A convenience sample of 25 English (n=15) and Spanish-speaking (n=10) lactating parents (<12 weeks postpartum) and lactation consultants were recruited to participate in an online focus group and complete a demographic survey. During focus groups, the team used a deliberative discussion approach and collected verbal and non-verbal responses while participants created accounts and interacted with MyMMMI Data. Focus group data was examined using a qualitative thematic analysis. Most participants were lactation providers (n=17, 65%) and college-educated (n=10, 58%) with a bachelor's degree. The themes identified were organization, aesthetics, motivational features, account creation/maintenance, and resources. Participants liked the purpose, design, and logging features. Areas of concern were account creation and the tone and nuance of the Spanish translations. Recommendations such as timers and push notifications were specified. Feedback revealed that MyMMMI Data is appealing, simple to use, engaging, and educational, but creating an account and translation tone needs improving. Participants stated they would continue using or recommend MyMMMI Data. Limitations include self-reported data and participant fidelity. Focus groups helped refine this smartphone application to address technical, functional, and language issues. Application and Spanish-language revisions are underway. Although participants requested timers and push notifications, these features are incompatible with the current application platform.

Comparisons Of Using Alcohol, Coping Strategies, Anxiety, And Depression Between Usa And Taiwanese College Students, Pi-Ming Yeh Associate Professor, Cheng-Huei Chiao Professor, Jennchang Liou Professor

Epsilon Sigma at-Large Research Conference

Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression.

Research Questions:

1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students?

2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression?

3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies?

Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was …

Restoring Effective Sleep Time In Post Cardiac Surgery Patients: A Quality Improvement Project, Brooke Watts Bsn, Rn

Epsilon Sigma at-Large Research Conference

Purpose: Restoring Effective Sleep Time in Post Cardiac Surgery Patients: A Quality Improvement Project

Brooke Watts, BSN, RN, DNP Student, Murray State University

Dr. Kristin Reid, DNP, APRN, ACNS-BC, DNP Program Director/Assistant Professor Murray State University

Aims: This quality improvement project was developed using DNP project guidelines provided through Murray State University and was designed to improve sleep in hospitalized cardiac surgery patients.

Processes: IRB approval was obtained from the healthcare institution and academic institution. This two-phase quality improvement project was designed to analyze the effects of a change in normalized hospital routines on self-reported sleep in post-cardiac surgery patients. …

Development And Evaluation Of Trauma Informed Care Education For Licensed Nurses, Kristina O'Meara

Epsilon Sigma at-Large Research Conference

Trauma informed care nursing education is crucial. Trauma informed care is a method of providing health care which understands the likelihood of past and present traumatic events in patients and families. The experience of past or present trauma often led to chronic diseases, substance abuse disorder, fragmented health care, fears surrounding health care, chronic stress, and other negative health consequences. The purpose of this project is to increase licensed nurses’ awareness and ability to practice trauma informed care in clinical practice, as well as promote policy initiation within the health care facilities. Method planning integrated the Knowledge to Action Cycle. …

Will The Implementation Of Nurse Competency Days Improve Knowledge And Satisfaction In Nursing Staff Of A Community Health Center?, Christina Morton

Epsilon Sigma at-Large Research Conference

Background: Nursing competencies are important for quality of care, patient safety, and identifying gaps in knowledge and skills. Patient harm has been linked to a lack of competency and insufficient policy and procedures.

Purpose: The purpose of this quality improvement project was to achieve standardization of nursing competencies within nurse-led clinics.

Aims: The aims of this project were to validate select competency days and determine the satisfaction of the competency days by the participants. The second aim of this project was to develop an electronic tracking form. A third aim was to develop and present a policy and procedure …

The Effects Of Age, Employment, Marriage, And Education On Academic Motivation In Undergraduate Nursing Students, Jessica Hamm Msn Rn Phd Student

Epsilon Sigma at-Large Research Conference

The Effects of Age, Employment, Marriage, and Education on Academic Motivation in Undergraduate Nursing Students

Purpose: The amount of research on non-cognitive variables affecting motivation is limited in nursing students. By using Self-Determination Theory, faculty can determine what motivates students to learn which will allow the creation of a learning environment that promotes student achievement.

Aim: To determine the effect age, marriage status, employment, and education level have on academic motivation in nursing students in the third semester of a baccalaureate nursing program within the framework of Self-Determination Theory.

Method: A descriptive correlational design was used to identify the effect …

Integration Of Mental Health And Enabling Services In A Rural School-Based Setting: An Evidence-Based Initiative, Kim Ferguson, Teresa Carnevale

Epsilon Sigma at-Large Research Conference

The Rural Expansion Program for At-risk Communities to Promote Health Outcomes through the Integration of Mental health and Enabling services in an Existing Primary Care School-Based Setting (REACH ME) program was established to increase access to mental health services at two existing school-based health centers (SBHC) in rural Hancock County, TN. These SBHCs are among the most unique in the nation, holding designations as federally funded qualified health centers - proving primary care services in a geographically isolated, rural, and medically underserved area. The aim of the project is increasing the number of patients receiving mental health and enabling services …

Quacking For Noggin: Farm Animal Assisted Therapy For The Traumatic Brain Injury Survivors, Alex Sargsyan

Epsilon Sigma at-Large Research Conference

The Aim

The aim of this study was to examine the effects of Animal Assisted Therapies with Farm Animals (AATF) with domesticated ducks on depression, anxiety, and self-efficacy in patients with traumatic brain injury (TBI) . Furthermore, the following hypothesis was tested:

Engaging in AATF with domesticated ducks will be associated with decrease in depression, anxiety, and an increase in self-efficacy.

Methods

The study examined the effects of AATF on anxiety and depression among patients with TBI. Time series quasi-experimental design structure was utilized. At the beginning of the study participants received Hospital Anxiety and Depression Survey (HADS) and General …