Medicine and Health Sciences Commons^™

Mantram For Mamas: A Pilot Study For Postpartum Women, Ritamarie Smedile

Dissertations

Objective: This pilot study launched an online Mantram Repetition Program (oMRP) using a virtual health portal that aimed to explore online portal accessibility, oMRP acceptance, and overall interface satisfaction among a sample of postpartum women.

Background: Postpartum depression remains one of the most common and severe childbirth complications, affecting more than 13% of women during the first three months after childbirth. Cognitive or behavioral talk therapy sessions and medication are the most frequently recommended treatments to alleviate symptoms. Although effective, women tend not to enroll or adhere to these modalities, suggesting they need alternative treatment plans. A possible alternative, mirroring …

Implementing Outpatient Screening Of Adult Patients At High Risk For Peripheral Artery Disease, Coral Roseberry

Doctor of Nursing Practice Final Manuscripts

Background: Peripheral artery disease (PAD) is a prevalent chronic vascular disease that remains often underdiagnosed and inadequately treated. The development of PAD increases both with age and with the presence of modifiable and non-modifiable risk factors. Risk factors for PAD include smoking, diabetes, hypertension, hyperlipidemia, and chronic kidney disease. Furthermore, PAD can be an indicator of systemic atherosclerosis which is associated with coronary artery disease, carotid stenosis, and cerebrovascular disease. Undiagnosed obstructive PAD contributes to damaging atherosclerotic sequelae such as claudication, ulcers, infections, peripheral neuropathy, and amputations. It is common for PAD to exist in the absence of symptoms; therefore, …

Assessing Genomic Literacy In Advanced Practice Nursing Students Before And After An Intervention, Guiselle Palomera

Doctor of Nursing Practice Final Manuscripts

Introduction

The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to examine genetics and genomics literacy in advanced practice nursing students before and after an intervention.

Background

As genomics continue to play an emerging role in healthcare, and advancements are introduced into clinical practice, it is critical that nurses be competent in genetics and genomics concepts. There is a fundamental need to incorporate genomics education into nursing school curriculum. However, studies have shown that the majority of faculty across nursing schools in the United States are ill-equipped to teach genetics and genomics concepts. Furthermore, many interventions to …

A Prescription For Exercise In Adolescents: A Pilot Project, Alexa Sikalis

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence based practice project was to increase physical activity (PA) times in pediatric patients who were not meeting the recommended guidelines of 60 minutes per day of activity. The goal was to educate adolescents on the benefits of exercise in order to increase their overall PA, even if it did not meet the recommended 60 minutes per day. The implemented education was also intended to motivate patients to establish healthy habits and minimize risks of poor health outcomes.

Background: Adolescence is characterized by development of neuronal plasticity and establishment of behavioral patterns. PA …

Algorithmic Bias: Causes And Effects On Marginalized Communities, Katrina M. Baha

Undergraduate Honors Theses

Individuals from marginalized backgrounds face different healthcare outcomes due to algorithmic bias in the technological healthcare industry. Algorithmic biases, which are the biases that arise from the set of steps used to solve or analyze a problem, are evident when people from marginalized communities use healthcare technology. For example, many pulse oximeters, which are the medical devices used to measure oxygen saturation in the blood, are not able to accurately read people who have darker skin tones. Thus, people with darker skin tones are not able to receive proper health care due to their pulse oximetry data being inaccurate. This …

Special Education: Inclusion And Exclusion In The K-12 U.S. Educational System, Erik Brault

Dissertations

The U.S. Department of Education defines students with disabilities as those having a physical or mental impairment that substantially limits one or more life activities. Previous research has found that students with disabilities placed in inclusive environments perform better academically and socially compared to students with disabilities who are placed in segregated environments. Yet, we know that inclusion in K-12 general education classrooms across the country is not consistently implemented.

The purpose of this study was to better understand the effects, if any, of general education high school teachers’ personal and professional experiences and knowledge on their attitudes toward educating …

Queering Healthcare Equity: Exploring How Two Community Health Centers That Specialize In Lgbtq Healthcare Frame Cultural Competence, Tommy Royston

Dissertations

Despite increased advocacy and funding, significant inequities in healthcare access, quality of care, and health outcomes have continued to persist for lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) communities. Intersecting marginalized identities such as race, gender, and disability compound health inequities faced by LGBTQ folx. These inequities are not random; rather, they result from deeply embedded homophobia, transphobia, ableism, and racism that pervade the U.S. healthcare system. An exploratory comparative case study was completed using qualitative data collection methods (i.e., key informant interviews, focus groups, and document analysis) to investigate how two California-based Federally Qualified Health Centers (FQHCs) that specialize in …

Nursing Education In Complementary Alternative Modalities: A Case Study, Deborah Bird

Dissertations

Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also …

3d-Wound Imaging: Precise, Consistent, And Efficient, Aubrey Halili

Doctor of Nursing Practice Final Manuscripts

Background: The most common method of obtaining wound measurements is the hand-ruler method. Studies show that the hand-ruler method results in the most inaccurate measurements with the lowest interrater reliability. Studies also show that using 3D-wound imaging yields the most accurate measurements with the best interrater reliability. 3D-wound imaging technology also increases efficiency by allowing users to obtain images and document assessments using one device at the bedside.

Purpose: The purpose of this project is to make the process of assessing wounds more efficient by decreasing the time spent on photographing, measuring, and documenting wound assessments by implementing the use …

The Gendered Profession: Resuscitating The Value Of The Male Nurse In The Pre-Health Undergraduate Eye, Madolyn Dolce, Anne Koenig Phd

Research Month

Background

Gender Gap: Women represent 88.5% of registered nurses in the U.S. (U.S. Bureau of Labor Statistics, 2021)

• Nurses have been devalued and degraded socially, professionally, and economically, especially with COVID-19 (National Nurses United, 2020).
• Reflects gender roles and societal perceptions of women as “lesser” and thus nursing is avoided by men.

Role/Goal Congruence Theory

• According to role congruence theory, social roles direct individuals on their life path, most notably in their career choices (Diekman & Eagly, 2008).
• Goal congruence theory suggests men and women tend to chase careers that align with agentic or communal goals, respectively (Diekman et al., …

The Covid-19 Crisis In The Cali-Baja Region, Allyson Teague, David A. Shirk Phd

Research Month

The central research question posed was “what have been the economic, public health, and social impacts of the Covid-19 crisis in the Cali- Baja region?”

The Covid-19 pandemic has impacted several communities around the world, and economic and health consequences have also exacerbated existing issues. In Cali Baja, the nature of having a population dependent upon cross-border travel and collaboration has resulted in unique ramifications for businesses, governments, and individuals. Understanding the ways in which this pandemic has, and continues to, spread as well as how it disproportionately affects specific populations provides needed insight for governmental responses for the inevitability …

Patient Perception Of Intensive Care Unit Discomfort, Essa Hakamy

Dissertations

Background: Discomfort has a significant effect on patient health and well-being; however, the symptoms are often difficult to address in ICU. Most patients in ICU are unable to communicate, making it difficult for physicians and nurses to distinguish between pain and discomfort. For example, artificial airways and assisted ventilation prevent patients from communicating. Patients may also have difficulty communicating due to delirium, fatigue, sedation, or neurological disease. Rationale: Discomfort has a considerable influence on patient health outcomes and well-being if not identified and addressed. Researchers have not explicitly explored discomfort apart from pain, which underscores the importance of studying the …

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

Implementation Of The Blunt Tip Cannula For Dermal Fillers To Decrease Adverse Events Intra And Post Treatment, Natalie Drone

Doctor of Nursing Practice Final Manuscripts

Abstract Title: Decreasing Adverse Events by Implementing Blunt Tip Cannula in the Administration of Dermal Fillers Intra and Post Treatment

Background: Dermal filler administration has become one of the most popular cosmetic procedures since dermal fillers were FDA approved in 1981. Although decreasing adverse events in dermal filler administration is a primary concern, aesthetic providers strive to provide patients with the most comfortable treatment experience possible without compromising aesthetic outcomes. Evidence has suggested that blunt tip cannulas provide a more comfortable delivery of dermal fillers and a lower risk of adverse events when compared with the standard practice …

“My Attitude On Telehealth Has Completely Changed.”: Facilitators And Barriers To Implementing Technology For Care Delivery In Community Mental Health Centers, Suzanne Meller, Justin Tauscher, Dror Ben-Zeev

Journal of Technology in Counselor Education and Supervision

The purpose of this study was to explore facilitators and barriers aiding community mental health centers in implementing technology-assisted care during the COVID-19 pandemic. Six key informants were interviewed and 28 clinicians were surveyed from three community mental health centers. Interviews focused on technology-assisted care implementation efforts and factors that facilitated adoption. Surveys focused on clinician beliefs and experience with technology-assisted care in addition to training needs. Barriers to technology-assisted care implementation included beliefs about the quality of virtual services and a lack of technology access. An increase in service utilization was reported. Technology-assisted care facilitators included reimbursement policy changes …

A Tide Of Technical Trends: Technology Competence Among Licensed Counselors, Brittany G. Suggs, Mary Sanderfer Stull, Spencer R. Baker, Kathie T. Erwin, David M. Savinsky

Journal of Technology in Counselor Education and Supervision

The inclusion of technology in mental health care can revolutionize the accessibility, affordability, and effectiveness of counseling services, while furnishing practical solutions to reduce mental health disparities and meet widening care demands. Steered by the Coalition for Technology in Behavioral Science (CTiBS) telebehavioral health (TBH) competencies, this study employed a descriptive survey design to investigate licensed counselors’ (LCs’) perceived technology competence in mental health care. The following research question steered the study’s exploration: What is the nature of perceived technology competence among LCs? The overarching hypothesis speculated that LCs’ exposure, familiarity, and current utilization of various mental health technologies would …

Correlates Of Health Literacy And Perceptions Of Burden Among Caregivers Of Persons Diagnosed With Chronic Illnesses, Mubarak Aldawsare

Dissertations

Background/Rationale: Greater attention is needed on factors effectively supporting caregivers because poor well-being of caregivers can hamper overall patient outcomes. Lack of awareness of caregiver burden has implications for healthcare systems globally. Caregivers may encounter various levels of burden as a result of providing long-term care to individuals diagnosed with one or more chronic illnesses. Caregivers with inadequate health literacy are more likely to experience feelings of uncertainty, and as a result, caregiver burden. Little is known about the impact of the health literacy of caregivers on the level of burden when providing care to individuals with complex care …

Effects Of Telephone Follow-Up On Medication Adherence And Rapid Readmission Among Discharged Adults With Schizophrenia Spectrum Disorders (Ssds), Romilynn Danko, Madalyn Cosensci

Doctor of Nursing Practice Final Manuscripts

High rates of 30-day readmission after acute care discharge are a big concern for patients with psychiatric disorders. These high rates not only reflect poor patient outcomes, but also result in higher hospital costs. For adults with schizophrenia spectrum disorders (SSDs), a review of current research shows that non-adherence to medication has been significantly associated with rapid readmissions and that using an intervention such as follow-up telephone calls after discharge can help prevent readmission through increased medication adherence. Using the Iowa model framework as a guide, the purpose of this evidence-based practice project was to pilot a post discharge procedure …

Fall Risk Assessment And Intervention To Reduce Fall-Related Injuries And Hospitalization In Older Adults, Pittawat Emerson

Doctor of Nursing Practice Final Manuscripts

Falls among older adults is a major issue that has become a leading cause of injuries and deaths. This study is an evaluation of fall-risk assessment using the Stopping Elderly Accidents, Deaths & Injuries (STEADI) tool and physical activity intervention in older adults aged 65 and above during their annual wellness visits to reduce fall-related injuries and hospitalizations. The results showed a reduction of fall-related injuries by up to 11.8% after the 12-week intervention. Patients with moderate-to-high fall risk saw a decrease in injury by 12.9%. Patients with moderate-to-high fall risk scores saw a decrease by 12.9%, from 25.9% to …

The Power Of Proactive Referrals: An Evidence-Based Practice Project To Improve Smoking Cessation Rates At A Community Health Clinic, Kristin Mcmahon

Doctor of Nursing Practice Final Manuscripts

Tobacco use is the leading cause of preventable morbidity and mortality in the United States today. Twenty percent of adults in the United States use tobacco costing the healthcare system approximately $225 billion annually in disease treatment. Most smokers want to stop smoking and most visit a healthcare provider each year making access to cessation interventions feasible. The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to increase smoking cessation among patients at a community health clinic by proactively linking patients to cessation counseling and support through implementation of the Ask-Advise-Connect model of smoking cessation. During …

Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, Jessica Cooke, Kamila Zasowska

Doctor of Nursing Practice Final Manuscripts

Background: On average, patients experience one to seven problems post-hospital discharge leading to increased unplanned emergency room visits, hospital readmission, and worse outcomes. The average cost of a single hospital admission is $15,477, an emergency room visit $1,389, and treatment for a surgical site infection $10,443-$25,546. Additionally, the Center for Medicare and Medicaid Services (CMS) imposes fines on hospital systems with high readmission rates. Currently, the Southern California hospital this project was implemented at has a 15.5% hospital-wide unplanned 30-day readmission rate with a national average of 15.2%.

Purpose: The purpose of this evidence-based practice project was to implement a …

Does Comfort Care Make You Uncomfortable? Use Of The Cares Tool For End-Of-Life Symptom Assessment And Management, Christina Covington

Doctor of Nursing Practice Final Manuscripts

Acute care nurses caring for end-of-life (EOL) patients often feel unprepared for and undereducated about this high-need population. According to current literature, many nurses lack adequate training in providing EOL care. This project aimed to improve symptom management of dying patients by providing acute care nurses education about EOL symptom assessment and medication use for symptom management. The revised Iowa model, which emphasizes clinician involvement, guided this evidence-based practice project. Sixteen acute care nurses received 30-minute in-person education, consisting of instruction in EOL symptom assessment and management via use of the CARES (comfort, airway, restlessness, emotional, self-care) tool and basic …

Evaluating The Effectiveness Of Education On The Misuse Of Corticosteroids And Antibiotics For Treatment Of Acute Pharyngitis, Samantha Kaikai

Doctor of Nursing Practice Final Manuscripts

Purpose: This evidence-based practice (EBP) project aims to pilot a nurse practitioner-driven education utilizing the American Family Physician guideline (AFP) “IDSA Updates Guideline for Managing Group A Streptococcal Pharyngitis.” Acute pharyngitis is a frequently observed condition in outpatient clinics, but its optimal management continues to be of concern due to the overuse of antibiotics and corticosteroid treatments. The AFP Guidelines for acute pharyngitis include using the Centor criteria to guide the plan of care and the evidence-based antibiotic therapy for patients who score >4 on the Centor criteria or test positive for the rapid point of care testing.

Background: In …

Forestalling: Decreasing Super-Utilizers In The Emergency Department Using Case Management Strategies, Kelly Chambers, Megan Gilmartin, Martha Narasimhan-Narayanan

Doctor of Nursing Practice Final Manuscripts

In 2019, it was estimated there were 18 million avoidable emergency department (ED) visits, totaling $32 billion in unnecessary healthcare spending. Super-utilizers (SU), individuals that seek care in the ED 3 or more times per year, account for a disproportionately large segment of healthcare consumption and costs. These patients inefficiently access the healthcare system and often fail to get the follow-up care that could prevent them from repeat ED visits.

This evidence-based project aimed to reduce unnecessary ED visits by at least 25% annually and have no use of the ED during the intervention period, by implementing social and medical …

Prediabetes Education To Prevent The Progression To Type 2 Diabetes, Peggy Mata

Doctor of Nursing Practice Final Manuscripts

This Evidenced-Based Project (EBP) aimed to decrease the incidence of patients diagnosed with prediabetes converting to Type 2 diabetes. By utilizing the Diabetes Self-Management Education and Support (DSMES) program, the project will enhance patient knowledge of diabetes and self-care practices. Education in patients diagnosed with prediabetes in a small community clinic in Tijuana, Mexico.

Background: The American Diabetes Association (ADA) recommends that patients diagnosed with prediabetes attend Diabetes Self-Management Education and Support (DSMES) classes. DSMES focuses on the lifestyle management of diabetes, and it facilitates knowledge, skills, and abilities necessary for optimal self-care. The focus is on supporting patient empowerment …

Treatment Evaluation Of Iron Deficiency Anemia In Women Of An Underserved Community, Bukola Olusanya

Doctor of Nursing Practice Final Manuscripts

Background/Purpose: Iron deficiency anemia (IDA) is the most common micronutrient deficiency globally. More than 20% of women experience IDA during the reproductive year. As the first-line treatment in IDA, oral iron supplement (IOS) is associated with gastrointestinal side (GI) effects, and it is often a barrier to achieving normal hemoglobin (Hb) and serum ferritin (SF) levels. Ineffective treatment fueled by a lack of guidelines increases the dilemma of dosing frequency in primary care, leads to poor quality of life, and increases the burden of anemia.

Intervention: Evidence showed that intermittent OIS is as effective as daily dosing. It is associated …

Implementation Of The Edinburgh Postpartum Depression Screening Tool To Screen Mothers For Postpartum Depression In The Pediatric Setting, Vera Nikolaychuk

Doctor of Nursing Practice Final Manuscripts

Postpartum depression (PPD) is a mood disorder affecting mothers after childbirth. Research estimates that approximately 11%-18% of mothers in the United States and one in seven women in California suffer from perinatal mood and anxiety disorder (PMAD) such as postpartum depression. Untreated postpartum depression not only costs United States billions of dollars in healthcare expenditure annually, but also leads to health complications for both mother and baby. The American Academy of Pediatrics (AAP) recommends screening for PPD at 1-,2-,4-, and 6- month well visits. A screening and referral program were implemented in a pediatric setting to identify mothers at risk …

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people were obese …

Screening People Experiencing Homelessness For Adverse Childhood Events (Aces), Priya Vishwanath

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement a screening tool identifying patients who have four or more Adverse Childhood Events (ACEs) and connecting them to resources to build protective resilience. Stress during the developmental years can lead to preventable health conditions that are costly and impede quality of life. Nine out of the ten leading causes of death are ACE related illnesses. These are caused by complications of toxic stress syndrome. During a 7-month period, 138 patients were screened; 45% had ACEs of four or more.

Smiling Mind: A Mobile Based Application To Reduce Stress, Agnes Rodrigues

Doctor of Nursing Practice Final Manuscripts

It has been recognized healthcare professionals experience high levels of stress at work with many working in environments characterized by high productivity targets, overtime, customer aggression, continuous organizational changes, and employee shortages. Mindfulness-based interventions such as mobile based meditation applications have gained popularity in the workplace given their potential benefits in decreasing workplace related stress, their ease of use, and cost-effectiveness. The purpose of this evidence based project (EBP) project was to reduce perceived workplace stress and to increase mindfulness using a mobile meditation application. Employees of an outpatient psychiatric clinic used the mobile meditation application Smiling Mind to meditate …