Remembering Time, Jonathan Carey

Capstones

My parents were dressed in their Sunday best, heading to a church revival. I was 12 and still the baby of the family, so staying home alone was out of the question. My grandmother Lillian, who preferred to be called Nana, came to babysit me. She relished a little time away from the doldrums and senior citizen gossip that engulfed the high-rise building where she lived,five minutes from my house in Petersburg, Virginia. That evening, as the sounds of “The Young and the Restless” echoed through the house, I tiptoed downstairs to give Nana a playful scare.

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

The Effect Of A Culturally Tailored Web-Based Physical Activity Promotion Program On Asian American Midlife Women’S Depressive Symptoms, Wonshik Chee, Sangmi Kim, Xiaopeng Ji, Sooyoung Park, Eunice Chee, Hsiu-Min Tsai, Eun-Ok Im

Asian/Pacific Island Nursing Journal

The benefits of physical activities on depressive symptoms have increasingly been reported in the literature, but the effect through which a Web-based physical activity promotion program alleviates depressive symptoms is not clearly known, especially among ethnic minority midlife women. The purpose of this pilot randomized control study is to examine the preliminary efficacy of the Web-based physical activity promotion program in enhancing the depressive symptoms of Asian American midlife women through increasing physical activity. This study adopted a randomized repeated measures pretest/posttest control group design. This study consisted of two groups of research participants: 18 in an intervention group and …

Asian/White Differences In The Relationship Of Maternal Age To Low Birth Weight: Analysis Of The Prams Survey, 2004–2011, Sangmi Kim

Asian/Pacific Island Nursing Journal

This study aimed to examine (a) maternal age patterns of low birth weight (LBW; birth weight < 2,500 g) for non-Hispanic (N-H) Asian and N-H White women, and (b) Asian–White gaps in LBW risk by maternal age and their mechanisms. Logistic regression analyses were performed on the Pregnancy Risk Assessment Monitoring System data of N-H Asian and N-H White women who delivered their first singleton birth without birth defects in 13 states between 2004 and 2011. Age- and race/ethnicity-specific LBW risk was estimated, unadjusted and adjusted for maternal risk factors (e.g., marital status, maternal education, pregnancy intention, stress, maternal morbidities, smoking, and prenatal care) and their interactions with maternal age or race/ethnicity. The interaction between maternal age and race/ethnicity was statistically significant (p < .0001) with covariates and interactions held constant. N-H Asian women showed a reverse W-shaped maternal-age pattern of LBW with the highest risk in their late 30s (OR = 1.56, 95% CI [1.26, 1.94]) whereas N-H White women experienced a maternal age-related increase in LBW. N-H Asian women were more likely to deliver LBW infant than their N-H White counterparts between their late 20s and late 30s, with the greatest racial/ethnic gap in their late 20s (OR = 4.19, 95% CI [3.33, 5.29]). Preventive strategies should be developed targeting N-H Asian women aged 25 to 39 years to reduce the Asian–White disparities in LBW. Considering the known maternal risk …

Connecting Culturally And Spiritually To Healthy Eating: A Community Assessment With Native Hawaiians, Mary Frances Oneha, Joan Dodgson, Mabel Ho`Oipo Decambra, Carol Titcomb, Rachelle Enos, Sandie Morimoto-Ching

Asian/Pacific Island Nursing Journal

Many of the chronic illnesses disproportionately experienced by Native Hawaiians are directly related to poor diets and long-standing obesity beginning in childhood. We report on the findings of in-depth key informant interviews (N = 14) that took place in two Native Hawaiian communities as part of a larger, community-based participatory research study that included a community assessment through individual interviews and focused group discussions, and a pilot intervention targeting pregnant women, their infants, and families. Four categories emerged from the qualitative analysis of interview transcripts that described an understanding of “healthy eating”: family roles and responsibilities, aspects of community …

Asian American Women's Resilience: An Integrative Review, Andrew Thomas Reyes, Rose E. Constantino

Asian/Pacific Island Nursing Journal

Asian American women face unique stressors that threaten their overall health and well-being. However, resilience is a phenomenon that allows individuals to develop positive adaptation despite adversities and challenges. This integrative review is conducted in order to explore the current state of knowledge regarding the resilience of Asian American women. Twelve databases were used to identify related articles: Academic Search Premier, CINAHL, ERIC, Ethnic NewsWatch, GenderWatch, ProQuest Dissertations and Theses Global, ProQuest Sociological Abstracts, PsycINFO, PubMed, SAGE (Psychology and Sociology collections), Scopus, and Web of Science. Twenty-one research studies met the inclusion criteria of the integrative review. Five common themes …

A Risk Stratification Model For Antihypertensive Medication Non-Adherence Among Chinese Immigrants, Wen-Wen Li, Chih-Ling Huang

Asian/Pacific Island Nursing Journal

The purpose of this study was to establish a risk stratification model for identifying Chinese immigrants at risk for non-adherence to antihypertensive medications. Questionnaires were self-administered to 200 Chinese immigrants in San Francisco, USA. Questionnaires included demographics, culture factors (e.g., Perceived Susceptibility in General, Perceived Benefits of Western Medication, Perceived Benefits of Chinese Herbs, and Health-Related Social Support), and medications adherence. Participants' mean age was 70.6 (±10.3) years. Three stratification factors were identified for non-adherence: Lower Perceived Susceptibility in General, lower Perceived Benefit of Western Medications, and longer Length of Stay in the United States. The probability of non-adherence was …

Safety Culture And Fall Prevention: A Collaborative Effort, Cecilia Cortina

Seton Hall University DNP Final Projects

Patient falls in the United States (US) range from 700,000 to one million annually and one third of those falls can be prevented (Du Pree, Fritz-Campiz & Musbeno, 2014). Twenty to 30% of falls are moderate to severe (Schimke & Schimke, 2014). As of 2009, The Joint Commission’s (TJC) (2015) Sentinel Event databank held 465 reports of hospital falls with injury; deaths that resulted in those injuries were reported as 63 percent. Common denominators resulting in patient falls with injury are poor assessment, lack of communication, failure to follow protocols, insufficient training and supervision, staffing levels, unsafe environments and lack …

A Quality Improvement Initiative Aimed At Reducing Complications Related To Iv Fluid Administration In The Acute Care Setting, Katherine Connolly

Seton Hall University DNP Final Projects

Purpose: The purpose of this quality initiative is to bridge the gap between evidence and practice related to the management of intravenous (IV) fluids in the hospital setting and to increase awareness regarding important quality issues, highlighting the critical role of nurses in effecting change in the health delivery system.

Significance of Project: The administration of IV fluids is one of the most common interventions in the hospital setting. The associated complication rate is higher than previously believed. Adverse effects impact recovery time, length of stay, cost, patient safety and survival. Related complications are largely preventable and unmet educational needs …

A Resident-Centered Dementia Care Staff Education Project To Reduce Challenging Behaviors At A Long-Term Care Facility, Margaret Huryk

Seton Hall University DNP Final Projects

Frequent use of antipsychotic medication (APM) for behavioral and psychological symptoms of dementia (BPSD) persists at high levels in long- term care (LTC) facilities despite extensive evidence of modest clinical benefits, serious adverse effects, public health advisories and a national initiative to improve dementia care. There is a gap between best-practice evidence and actual clinical practice related to pharmacological and nonpharmacological care for persons with dementia (PWD) and BPSD and/or neuropsychiatric symptoms (NPS) of dementia. The literature shows that clinicians often ignore FDA (Food and Drug Administration) warnings, CMS (the Centers for Medicare and Medicaid Services) initiatives and expert opinion …

Self-Care Among Older Adults With Heart Failure, Sumayya Attaallah, Kay Klymko, Faith Pratt Hopp

Social Work Faculty Publications

Background: It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. Purpose: The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. Methods: A literature search was completed and resulted in including 28 studies. Results: Multiple factors have been reported as barriers to self-care …

Feasibility Study For Rural Health Clinic, Cynthia A. Noble

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Cindy Noble

The purpose of this study was to determine the feasibility of a rural health clinic in the Adair, Oklahoma area. A mixed-mode survey was sent to 2,890 households within a certain zip code for the Adair community and surrounding area. A link for the survey was also included so the survey could be accessed on line. The total number of surveys returned was 88. The respondents of the survey did show a willingness to use healthcare clinic if one were available in Adair, Oklahoma. The surveying also showed that the majority …

Role Of The Endocannabinoid System And Medical Cannabis, Sabrina Jarvis, Sean Rasmussen, Blaine Winters

Student Works

Our bodies produce substances called endocannabinoids which attach to receptors within the endocannabinoid system (ECS) impacting physiological processes on a daily basis. The cannabis plant contains over 100 different cannabinoids which also manipulate the ECS. Knowledge about these interactions have led to an increase in cannabis based pharmacological studies. Providers should have a basic understanding about how the ECS works and how cannabis is being used to treat certain illnesses. This article presents what is currently known about the ECS and how cannabis based medicines impact it, as well as the current laws providers need know regarding cannabis use.

Delayed Umbilical Cord Clamping: A State Of The Science, Landynn E. Ouellette

Senior Honors Projects, 2010-2019

The purpose of this paper is to explore the state of the science related to delayed versus early umbilical cord clamping. This interprofessional change in practice and protocol needs to take place within obstetric practice, which can be made up of obstetricians, midwives, nurse practitioners, and nurses. Patients must be educated by their providers so that they can better understand the care being performed. A search of the literature published through PubMed was conducted using the key phrases delayed umbilical cord clamping (DUCC), benefits of delayed cord clamping, and umbilical cord protocols. The search yielded 133 titles, which was limited …

Using Community Health Workers In Collaboration With Nurse Case Managers In Effecting Change In Quality Of Life For Heart Failure Patients, Patra Hull Reed

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness in improving the quality of life among heart failure patients with the addition of the role of Community Health Worker (CHW) to a current continuum case management model. The study also addressed the increased need for more appropriate and cost-effective chronic care management for heart failure patients. Hospitals and healthcare systems are being challenged to find innovative ways to decrease readmissions, decrease unnecessary emergency room visits, increase patient adherence, and manage chronic disease, all improving the patient’s overall quality of life. Studies show that approximately 76% of heart failure patients have a …

Procedural Sedation: Policy, Practice & Knowledge, Jennifer A. Martin

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Diagnostic and invasive procedures performed outside of the operating room with nurse- administered procedural sedation are increasing. As procedural sedation practice national guidelines are evolving, there are inconsistent state regulations and a great deal of variability in staff training. These challenges lead to potential knowledge gaps and practice variation that create unsafe patient environments. A local hospital has continued to experience near miss events when procedural sedation is administered. In an attempt to investigate this issue and create improved practice, an organizational policy analysis was conducted. The aims of this project were to: 1) analyze current hospital policy content compared …

Shared Decision Making For The Appropriate Use Of Antibiotics For Respiratory Tract Infections, Kristina Blyer

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Objective- Determine the effectiveness of shared decision making to 1) increase decisional comfort with the appropriate use of antibiotics for respiratory tract infections and 2) maintain antibiotic prescribing rates at current levels.

Participants- English speaking college students age 18 and over diagnosed with a respiratory tract infection in the general medical clinic of a university health center from August 31, 2015-May 6, 2016.

Methods- Pre- and post-intervention surveys used to measure decisional conflict of students. Intervention included staff training in shared decision making and the use of a decision aid in clinical practice.

Results- Students who received routine care …

Implementing Post-Hospital Interprofessional Care Team Visits To Improve Transitions Of Care And Decrease Hospital Readmission Rates, Stacy M. Baldwin

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Background: Today’s healthcare climate is comprised of a population of patients who are more complex, presenting with multiple comorbidities, and requiring frequent hospitalizations. It is imperative for acute care and primary care landscapes to bridge silos and form collaborative relationships to ensure safe and effective transitions of care from hospital to home. An interprofessional, post hospital follow-up clinic is one approach that can be utilized to improve transitions of care and decrease preventable hospital readmissions.

Purpose: The purpose of the project's discharge clinic was to improve transitions of care and decrease thirty day hospital readmission rates. The primary objective of …

Segregation Or Integration: Exploring The Interprofessional Collaboration Of The Sexual Assault Response Team-A Pilot Study, Phyllis E. Adams

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Sexual Assault Response Team (SART) has been functioning since the early 1970’s with little research on the dynamics of the members’ interprofessional collaboration practice. A current gap in the literature is research specific to the assimilation of the disciplines within the SART and the collaborative practice of the SART. The purpose of this project study is to clarify the 12 subscales of Interprofessional Collaborative Practice (motivation, role expectations, personality style, professional power, group leadership, communication, coping, social support, organizational culture, organizational aims, organizational domain, and organizational environment) and explore how each profession perceives these subscales. The sample participants were …

Improving Provider Compliance Of The Naepp 2007 Asthma Guidelines Through The Electronic Health Record (Ehr) In A Pediatric Primary Care Practice, Tiffany L. Kidd

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Expert Panel Report -3 (EPR3) NAEPP 2007 evidence-based clinical asthma guidelines were developed to provide evidence-based high-quality patient care that leads to improved outcomes. A literature review showed that healthcare providers do not routinely follow the asthma guidelines. The purpose of this project was to develop and implement an evidence-based asthma electronic health record (EHR) template in a pediatric office to improve provider compliance to the guidelines resulting in improved outcomes for children with asthma. The study was conducted over a period of four months from January - April 2016. An EHR asthma protocol template and training for providers …

Examining The Implementation Of The Patient-Centered Recovery Model In Psychiatric Nursing, Nicole K. Rossi

Senior Honors Projects, 2010-2019

The Recovery Care Model is the recommended evidence-based model for delivering holistic, patient-centered care for mental health clients. The model is a more therapeutic approach than the traditional medical model and upholds the ideas that psychiatric clients are more than just their illness, should be respected as unique individuals, and provided with hope and empowerment in their care while being given the opportunity for informed and autonomous decision-making. Although research has shown support for the Recovery Care Model, its implementation has not been fully accomplished in all psychiatric facilities. Of all of the members of the health care team, nurses …

A Systematic Review Of Complimentary Therapies To Treat Symptoms Of Post-Traumatic Stress Disorder In The Aftermath Of Domestic Abuse, Jordan A. Meeks, Saida Byrami

Senior Honors Projects, 2010-2019

Objectives: Explore the impact of intimate partner violence (IPV) on the health of female survivors. Identify complementary therapies that alleviate symptoms of psychological health impacts of IPV on women’s health.

Method: An exhaustive search of published, peer reviewed literature on complementary therapies and IPV was conducted. Databases included PubMed and CINAHL. Each article reviewed was published between the years of 2002 and 2016. The initial search produced 112 articles, abstracts of all studies were reviewed and studies were included if they addressed; a) complementary and alternative therapies, b) post-traumatic stress disorder, anxiety, and depression and, c) the impact of IPV …

Improving Quality And Efficient Communication Between Providers And Nursing - A Psychiatric Sbar Tool (Psych), Karen Lee Richards

Master's Projects and Capstones

IMPROVING QUALITY AND EFFICIENT COMMUNICATION BETWEEN

PROVIDERS AND NURSING - A PSYCHIATRIC SBAR TOOL (PSYCH)

Karen Richards

University of San Francisco

Abstract

Effective communication is the cornerstone of providing safety and quality healthcare. However, nursing and providers often share information inequitably, as these disciplines are trained differently regarding communication. Providers are taught to be brief, accurate and focused while nurses are taught to be descriptive and holistic. These differences have led to disparity in the sharing of valuable patient information, subsequently leading to increased frustration, inefficiency, and medical errors. Multiple studies provide evidence that poor communication is a major contributor …

Exploring The Experience Of Foster Parents As They Care For Children Who Are Making The Transition From The Hospital Into The Foster Home, Maximilian Veltman

Nursing ETDs

This study explored the perceptions foster parents have about their work as caregivers of foster children who are hospitalized and then discharged from the hospital into a foster home. The numbers of children in foster care nationwide has decreased over the past 25 years, yet the proportion of children in foster care who have significant health conditions has increased dramatically (Wang, Edelstein, Waldinger, Lee & Bath, 2011). There has also been significant attrition of qualified foster parents who are able to care for foster children with significant health needs (Pecora, Whittaker, Maluccio, Barth & DePanfilis, 2009; Vig, Chinitz & Shulman, …

Improving Employee Engagement Through The Development Of An Enterprise Performance Management System, Carlton D. Abner

Doctor of Nursing Practice (DNP) Projects

There is ample evidence of our health care delivery system relying heavily on value-based outcomes. The increased focus on outcomes has required health care organizations to adjust how they approach data and how they successfully implement performance management systems. These performance management systems help the organization identify, measure, and report the organization’s performance at an enterprise level using key performance indicators clearly linked to the organization’s overall strategy. As one organization began implementing an enterprise performance management system, the goal of this project was to show how participating in projects with that level of strategic impact can lead to improved …

Transforming Self And Systems Through Implementation Of A Caring Coach Leader Program, Priscilla Javed

Doctor of Nursing Practice (DNP) Projects

Assistant nurse managers and nurse managers, often referred to as middle managers, have a direct impact on daily hospital operations, clinical work environments, delivery of high quality safe patient care, and patient outcomes. The stressful demands of this role have caused turnover rates to soar above the national average on some of the inpatient hospital units. Instability of nursing management oversight negatively effects staff job satisfaction and delivery of high quality safe patient care. In reviewing the organizations initial orientation program for transitioning middle managers into their new role, it was missing the supportive guidance of a coach. A Caring …

Development Of A Toolkit To Enhance Nursing Education Of Veteran Health Concerns, Carlee Y.S. Balzaretti

Doctor of Nursing Practice (DNP) Projects

Abstract

U.S. Veterans are a vulnerable patient population, more prone to health disparities as compared to the general population. There are 21.8 million Veterans currently in the United States, with the majority receiving their healthcare outside of the Veteran Health Administration. Veterans form a culture that is steeped in military tradition and it is essential that healthcare providers have knowledge regarding this vulnerable population to provide care that is culturally appropriate. In response to the Veteran healthcare crisis, the Department of Veteran Affairs initiated the Veteran Affairs Nursing Academy Partnership (VANAP), a joint venture between VHA medical centers and schools …

Nursing Student Work-Study Internship: Partnering To Bridge The Education-To-Practice Gap, Jonalyn M. Wallace

Doctor of Nursing Practice (DNP) Projects

Abstract

Discussed for decades, the need for transitional experiences bridging educational and practice settings gained momentum in the mid-1970s with the release of Kramer’s groundbreaking book Reality Shock: Why Nurses Leave Nursing. Nursing student internship programs were developed in the 1970s as one effort to address this issue. The Northern California Region of Kaiser Permanente partners with five universities to conduct the Nursing Student Work-Study Internship Program (WSP). The program provides senior level nursing students with a paid internship in clinical practice settings, working under the supervision of RN preceptors. The aim of the program is to improve the …

Developing An Electronic Health Record Training Program For New Employees, Crystal D. Figlietti

Doctor of Nursing Practice (DNP) Projects

In May 2015, an electronic health record (EHR) was implemented at an urban, long-term care facility. This facility is part of the county Department of Public Health (DPH) and was one of the last locations to implement the designated EHR system. The unique nature of the facility compared to the smaller, health care centers within the DPH network necessitated development of a customized training and onboarding program for new employees. It was not possible to duplicate an existing training program. The registered nurse (RN) informaticist assigned to the EHR used data from nursing staff surveys and information collected through a …

Impact Of Nurse Fatigue And Nursing Handoffs On Patient And Nurse Safety, Melody A. Seitz

Nursing Theses and Dissertations

In healthcare today, patient safety continues to be a major concern. Nurse fatigue from long work shifts and inadequate patient handoffs may lead to errors and near errors that harm patients and nurses. The intent of this study was to fill a gap in understanding the effect shift length has on patient safety and maternal newborn nurses’ personal safety. A cross sectional survey design was administered via Qualtrics, a web-based online software program. Participants included two groups of maternal newborn nurses. One group worked 8-hour shifts (N = 70) and the other group worked 12-hour shifts (N = 151). Statistical …