Medicine and Health Sciences Commons^™

Reducing Risk Factors Of Diabetes Mellitus Type Ii Development In Veterans Post Military Discharge Through The Patient Aligned Care Team Model And The Utilization Of Preventive Programs Involving Lifestyle Changes., Jeni Grundy

Doctor of Nursing Practice (DNP) Manuscripts

Diabetes Type II (T2DM) prevalence is rising in America, becoming a focus for disease prevention. The American Diabetes Association (ADA) has highlighted the need to tackle the increased T2DM precursor, prediabetes, which ultimately leads to T2DM if risk factors remain unaddressed. One group of the American population with a high rate of prediabetes is the 9/11 Veteran cohort. The Veterans Affairs (VA) system has numerous health promotion missions. This system has highlighted its initiatives to address the development of T2DM. Specific to the 9/11 group, their primary T2DM contributory risk factor is obesity paired with the low utilization of already …

Decreasing Hospital Acquired Pneumonia In Adult Patients By Patient Care Technicians: Education With A Focus On Oral Care And Tooth Brushing, Amanda Nicole Lee

Master's Projects and Capstones

Hospital acquired pneumonia’s (HAPs) are unfortunate and preventable events quality improvement efforts should focus on. At a Northern California Hospital, there was an unmet HAP rate goal of 2.3 (20 out of 8795 patients) against a target goal of 2. This increase in HAP rates, both non-ventilated and ventilated was a call to action to reduce HAP to the target goal. The quality improvement project specifically aimed to reduce HAP rates on medical-surgical units through an ultra-brief refresher on the hospital validated and endorsed ROUTE bundle. The education focused on oral care completed by the patient care technicians (PCT’s). The …

Reducing The Risk Of Central Line Associated Blood Stream Infection With Chlorhexidine Gluconate Education, Scarlett Ocon

Master's Projects and Capstones

Problem: A nosocomial central line-associated bloodstream infection is a preventable infection that is costly and potentially fatal. In order to combat bloodstream infections chlorhexidine gluconate wipes have been used as antiseptic. Medical surgical units do not have accessible CHG for bathing purposes. In addition, the staff lacks knowledge of how to use CHG wipes. The current standard bathing practice on this unit consists of using soap and water or disposable washcloths spontaneously without a predetermined time. The aim of this quality improvement project is to educate the registered nurses (RNs) and certified nurse assistants (CNAs) on the benefits of daily …

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health, …

School-Based E-Cigarette Education Curriculum, “Team No Vaping”: Impact On Knowledge Of E-Cigarettes, Harm Perception, And Media Literacy Among Middle/High School Students, Niran Tamrakar

Capstone Experience

E-cigarettes are the most used tobacco products among middle/high school students. Youth e-cigarette use is at an epidemic level. While school-based vaping prevention programs exist, there is limited evidence on the effectiveness of such programs. To address vaping prevention among this vulnerable population, University of Nebraska Medical Center (UNMC) in collaboration with the Tobacco Education & Advocacy of the Midlands (TEAM) developed and implemented a school-based e-cigarette education curriculum, “TEAM No Vaping.” This study evaluated the impact of the “TEAM No Vaping” program on increasing the knowledge, harm perception, and susceptibility to e-cigarettes, and vaping media literacy for vaping prevention …

The Effect Of Oral And Topical Antibiotics On Foreskin Inflammation And Hiv Target Cells In Ugandan Men., Zhongtian (Eric) Shao

Electronic Thesis and Dissertation Repository

Penile circumcision reduces HIV susceptibility by up to 60% in men; however, many men prefer to remain uncircumcised for personal or cultural reasons. Penile circumcision protects against HIV by reducing anaerobic bacteria on the penis. Penile anaerobes cause local inflammation and the recruitment of HIV-susceptible CD4+CCR5+ cells, increasing the likelihood that exposure to HIV during intercourse results in infection. To determine if a non-surgical intervention can reduce penile anaerobes and HIV target cells, we randomized men to antimicrobial treatment prior to circumcision. To be able to quantify the effect of antimicrobials, we developed a novel deep-learning algorithm to quantify HIV …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

Wellness And Longevity Program For Adults And Older Adults, Oliver D. Fay

Department of Occupational Therapy Entry-Level Capstone Projects

There are many areas of practice to choose from in the field of Occupational therapy (OT). OT has an incredibly diverse career path, with new opportunities being created every day. I completed my doctoral capstone experience at Iridium Enterprises with Dr. Aaron Green, who has a wealth of experience in business and entrepreneurship. My ACOTE focus areas were administration and program development. I wanted to learn how a business was properly developed and managed from the ground up.

Through this experience, I learned how to methodically approach market research and how to narrow in on a business idea. Our goal …

Chronic Obstructive Pulmonary Disease (Copd), Joseph Earich

Nursing Student Class Projects (Formerly MSN)

Background: Chronic Obstructive Pulmonary Disease (COPD) is an irreversible, preventable respiratory disease characterized by airflow limitation and obstruction that is usually progressive. COPD affects millions of people globally and over $7 billion dollars is spent on COPD related hospitalizations in the U.S. annually. This poster includes information focused on COPD, the underlying pathophysiology, clinical manifestations, diagnosis, nursing care implications, and treatment.

Methods: Research articles within the last five years were obtained using keywords such as COPD, pathophysiology, treatment, prevention, emphysema, and chronic bronchitis from databases EBSCO and PubMed. The data and quality of these articles were assessed and information compiled …

Three Essays About Preventing Mental And Behavioral Disorders, Snehal Lopes

All Dissertations

Prevention efforts in the public health field operate at various levels, including primary prevention among those without a disease of interest, secondary prevention among persons at high risk or showing early signs of the disease, and tertiary prevention among persons with the disease. The three essays presented in this dissertation are centered around the theme of prevention, and taken together, have implications for prevention at the primary, secondary, and tertiary levels. Specifically, the essays focus on the prevention of depressive disorders and the prevention of behavioral and mental health correlates for depression in the context of various populations (general adult, …

Acute Kidney Injury, Chelsey Benner

Nursing Student Class Projects (Formerly MSN)

Acute kidney injury (AKI) is a common complication of surgical procedures and can lead to increased morbidity and mortality. AKI can be described by a sudden decline in kidney function, evidenced by elevation of serum creatinine, elevated blood urea nitrogen levels, and a decreased glomerular filtration rate (McCance & Huether, 2018, p. 1360). Optimal perioperative management and recognition of patients at high risk for AKI is important in preventing the development of acute kidney injury.

Reducing Catheter-Associated Urinary Tract Infections In The Pediatric Intensive Care Unit, Maria Smith

Dissertations

Problem: CAUTIs (catheter-associated urinary tract infections) are a common hospital-acquired condition (HAC) that increase length of hospital stays, hospital costs, and risk for patient mortality. CAUTI rates in a PICU increased in 2021 from the year 2020. A rapid cycle PDSA revealed nurses were not using soap and water for foley catheter care, which is the recommended cleanser by the Centers for Disease Control and Prevention (CDC).

Methods: An observational descriptive design was used to evaluate foley catheter cleaning and CAUTI rates. PICU nurses completed behavior surveys regarding foley catheter cleaning practices. An education intervention occurred when nurses answered anything …

Improving Colorectal Cancer Screening In Primary Care, Bushra Iqbal

Doctor of Nursing Practice (DNP) Projects

Colorectal Cancer (CRC) is the second leading cause of cancer related deaths in the U.S., although it is preventable with adequate routine screening. Medically underserved minorities and immigrants require screening program awareness in their respective communities. The incidence of CRC remains markedly high despite the screening modalities among various populations. In the United States (U.S.), there were approximately 147,950 reported CRC diagnoses, 53,200 deaths, and over 35.2 cases per 100,000 in California alone reported in 2020 (Siegel et al., 2020). Healthcare providers can prevent colorectal cancer (CRC) through adequate routine screening. Various screening practices are widely implemented in primary cases …

Lifestyle Modification Interventions On Hemoglobin A1c Level In Patients With Type Ii Diabetes Mellitus In An Underserved Community: A Pilot Project, Anniesatu Newland

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) is a pandemic of great concern among the nutrition-related non-communicable diseases. Its prevalence is mounting worldwide, particularly in underserved communities and minority groups. In 2019, 463 million people were diagnosed with T2DM, a number expected to increase to 578 million by 2030 globally. The prevalence of T2DM is increasing the mortality rate from cardiovascular complications. The social and health costs of treating this disease is currently 11% of the global health budget. This project aims to utilize an evidence-based approach to assess lifestyle interventions' effectiveness at decreasing the Hemoglobin A1c levels in T2DM individuals after …

Save Lives And Sanitize: Prevention Of Surgical Site Infections Post-Cesarean Section Through Increased Hand Hygiene Compliance, Lindsay N. Nance

Master's Projects and Capstones

Problem: Surgical site infections (SSIs) occur in 3-15% of cesarean sections, making SSIs one of the most common hospital-acquired infections (HAIs). Surgical site infections (SSIs) have increased within a Labor & Delivery (L&D) unit in a large California teaching hospital for the past three years, affecting reimbursement and creating a range of adverse outcomes for patients. Performance of consistent and thorough hand hygiene practices is key to preventing infection, yet the unit’s hand hygiene compliance of 66.7% is well below the facility’s target goal of 90%. Based on recommendations from the organization’s Infection Prevention & Control (IPC) specialist, the …

Nutrition On The Prevention And Treatment Of Depression, Gracie Polen

Nursing | Senior Theses

Today, the general population consumes a diet high in sugars, saturated fats, incomplete protein sources, and the tendency to exceed the bodies caloric requirements. The trend of obesity due to poor dietary habits is alarming. Mental illness has increasingly risen over the past decade. Specifically, the incidence of depression has reached a startling rate. The relationship between poor dietary intake and depression have grown together and it is imperative that methods are introduced to aid in resolving this issue. The prevention and treatment of depression needs to be explored through alternative methods. Healthier dietary choices have been shown to have …

Multimodal Approach To Chronic Pain Management And Prevention Of Opioid Use Disorder, Hannah Elston

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background. Chronic pain (CP) is a major public health problem that affects one-third of the population and can interfere with the activities of daily life and cause decreased quality of life. Patients with CP have been increasingly prescribed opioids, contributing to the rise in the opioid epidemic. Due to the long-term nature of CP, the use of opioids as the sole treatment for CP can cause tolerance and increased dosages overtime which can lead to addiction and potentially overdose. Therefore, CP treatment should include multimodal approaches to treatment to prevent opioid misuse, opioid use disorder (OUD), and overdose. Multimodal treatments …

Qualitative Analysis Of South Dakota Community Health Needs Assessments, Rachel Greiner

Honors Thesis

The supplemental nutrition program of women, infants and children (WIC) is a nationwide program designed to give women and children access to basic nutritional foods, breastfeeding services, and healthcare referrals. WIC has been shown to help prevent some diseases such as nutritional deficiencies or type two diabetes by requiring participants to attend pre- and postnatal appointments and nutritional counseling. The effectiveness of the WIC program is not well known in individual states. The purpose of this research is to identify trends of the WIC program and resources within South Dakota through an analysis of the community health needs assessments. The …

Implementation Of An Evidence-Based Bundle To Reduce Hospital Acquired Pressure Injury Harm Rates In The Intensive Care Unit: A Quality Improvement Project, Jessica Tripp

DNP Scholarly Projects

A pressure injury (PI) is a condition in which prolonged pressure or shear causes localized damage to the soft tissue and skin and is usually over a bony prominence (National Pressure Ulcer Advisory Panel (NPUAP), 2016). PIs can increase morbidity and mortality, increase length of stay, increase infection rates, increase healthcare costs and decrease quality of life (Agency for Healthcare Research and Quality (AHRQ), n.d.; Coyer et al., 2017). PIs are largely preventable yet continue to occur, despite the growing number of high-quality research articles that focus on this problem. Quality improvement initiatives are an effective way to translate evidence-based …

Increasing Utilization Of The Delirium Prevention Protocol In Post Cardiovascular Surgery To Improve Quality And Safety Of Healthcare, Kristin Luce

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Abstract:

Background and Objectives: Post-operative delirium (POD) is the most common complication seen following surgery in older adults. Two-thirds of delirium cases are diagnosed late or missed in everyday practice across health care settings which can lead to a variety of long-term complications. POD prevalence can be reduced within inpatient practice settings by utilizing established screening tools, such as the Confusion Assessment Method (CAM). This project aimed to increase nurse screening of delirium and provide education on POD to nursing staff on the post-cardiovascular surgery unit to increase utilization of the delirium prevention protocol.

Methods: Educational sessions provided to nursing …

Best Practices For The Prevention And Treatment Of Microcytic Hypochromic Anemia In Infancy, Janelle Paredes

Nursing | Senior Theses

Background: Microcytic hypochromic anemia is the most common nutritional deficiency in the world. This type of anemia is commonly found during infancy due to the lack of iron-fortified foods after six months of age. The effects linked to this deficiency can cause developmental delays and behavioral disturbances in infants if not treated immediately. Therefore, it is important for nurses to find the best practices to prevent microcytic hypochromic anemia to decrease its prevalence in infancy.

Objective: To find the best nursing practices for the prevention and treatment of microcytic hypochromic anemia in infancy.

Methods: This research will utilize …

A Pathway For Inclusive Innovation In Pediatric Mental Health: Prevention And Intervention Using Technology, Kate Corinne Bennett

DSW Capstone Projects

It is no secret that access to quality healthcare is difficult for citizens to achieve in the United States. Racism, discrimination, and oppression further exist at the root of compounding social problems, including limits in minority access to mental health services. The COVID-19 pandemic has also exacerbated mental health problems for young children, especially those who are already underserved and at risk. For these reasons, it is imperative that the social work profession emphasizes innovative approaches to equitable treatment access, including a focus on early intervention and the use of technology. Product one of this capstone engages a systematic review …

Factors Associated With The Uptake Of Hiv Testing Among African American Male College Students, Brittney Sade Washington-Ball,Drph

Walden Dissertations and Doctoral Studies

HIV testing rates are much lower among African American male college students than male college students of other racial groups. Routine HIV testing on college campuses can decrease HIV rates among African Americans and increase students' awareness of their HIV status. This study was an investigation of factors associated with HIV testing among a sample of 140 African American male college students. The health belief model guided the research study and served as the theoretical framework to examine the influence of factors such as the location of testing, STD status, number of sexual partners, insurance coverage, health information, and alcohol …

Clinical Practice Guideline On Suicide Prevention Among Adolescents, Beltta Gangwab Tachi

Walden Dissertations and Doctoral Studies

AbstractIncreasing rates of suicide among adolescents in the United States is an unsettling problem whereby suicide is the second leading cause of mortality among adolescents. Although interventions exist to address this problem, there is a lack of clinical practice guidelines (CPGs) to assist healthcare providers to identify and prevent adolescent suicide. Guided by the zero-suicide model, the purpose of this project was to develop a CPG to address this gap in practice. A literature review on adolescent suicide prevention resulted in 24 peer-reviewed articles published in the past 5 years that were graded and arranged in a literature matrix. These …

Childhood Anxiety And Roles Of Parents, Educators, And Pediatric Healthcare Providers In Addressing Protective Factors, Gabriela Zamora-Ahlstrom

Walden Dissertations and Doctoral Studies

AbstractChildhood anxiety affects over 32% of youth in the United States, and when left untreated, contributes to poor school performance, social difficulties, truancy, school dropout rates, juvenile delinquency, substance abuse, and family and community difficulties. Preventing childhood anxiety by implementing effective protective factors for children can eliminate many of these outcomes. Using the biopsychosocial theory and social work systems theories, this study involved exploring the beliefs and attitudes of parents, educators, and pediatric healthcare providers in an affluent suburban community of Detroit (Rochester/Rochester Hills, MI), regarding their roles in providing protective factors against childhood anxiety. A generic qualitative research design …

Understanding The Perspectives Of African American Gay And Bisexual Men Toward Hiv, Victor Onwezi , Ikechukwu Nwanguma

Walden Dissertations and Doctoral Studies

There is an urgent need to stop the HIV epidemic among African American gay and bisexual men in the United States. The purpose of this basic qualitative study was to identify the health issues responsible for the HIV epidemic among African gay and bisexual men. Two theoretical frameworks that guided the study were the transtheoretical model and the syndemic theory. The study's research involved understanding African American gay and bisexual men's perspective toward HIV infections and their understanding of possible reasons HIV rates appear to increase in their community. Semi-structured telephone interviews and field notes were used to collect primary …

Staff Education On Reducing Burnout In Mental Health Professionals Through Restorative Yoga Practice, Rina Buenaventura Vickery

Walden Dissertations and Doctoral Studies

Mental health professionals (MHPs) are at considerable risk for stress and burnout because of the nature of their work. Management and prevention of stress and burnout (e.g., through restorative yoga) may enable MHPs to avoid feelings of anxiety, depression, and apathy; lack of energy; and the development of unhealthy coping skills, such as substance and drug use. The purpose of this project was to create a staff education to assist MHPs in managing stress and burnout through yoga practice and mindfulness. The theoretical framework for the staff education was Kapp’s adult learning theory. An evidence-based PowerPoint presentation containing the staff …

Implementing Quality Improvement Strategies In Real-World General Practice- A Study Focused On Cardiovascular Disease, Charlotte Hespe

Theses

Introduction

General practitioners (GPs) are central to cardiovascular disease (CVD) prevention and management. However, multiple studies show they have sub-optimal assessment and management of CVD risk. The central question addressed in this thesis was: How do we translate preventive care guidelines into the real world of Australian general practice through Quality Improvement Collaboration (QIC)?

Methods

The research comprised of four studies. The first examined the experiences of stakeholders participating in a quality improvement collaboration (QIC) intervention undertaken in Australian primary care [the Australian Primary Care Collaboratives [APCC] program], and the second assessed implementation of the 2012 CVD risk management guidelines …

Characteristics And Regions Of Hospital Locations And The Risk Of Postpartum Hemorrhage., Zahra Shahin

Electronic Theses and Dissertations

Background: Postpartum hemorrhage (PPH) is one of the contributing factors to maternal morbidity and mortality that in addition to maternal risk factors, may be related to other factors such as obstetric practice and clinical management of postpartum hemorrhage. Therefore, this study aimed to explore the association of postpartum hemorrhage with characteristics and regions of hospital locations across the United States, as the outcomes may create opportunities to improve policies and protocols regarding PPH management more effectively. Method: A retrospective study was performed using the 2018 National Inpatient Sample (NIS) database. Low-risk delivery hospitalizations involving the third stage of labor with …

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …