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Implementation Of An Opioid Risk Assessment Tool, Stacey Cuomo 2017 Seton Hall University

Implementation Of An Opioid Risk Assessment Tool, Stacey Cuomo

Seton Hall University DNP Final Projects

The increased prevalence of opioid use in society has led to an increase in surgical patients with a history of such use. Patients who use or are addicted to opioids have different tolerances and responses to anesthesia than non-opioid users, and will require different care than non-users both pre- and post-operatively. The means to identify this population prior to a surgical procedure is needed as a way to organize, plan and manage patient care during the perioperative period. An Opioid Risk Assessment Tool (ORAT) was used as a way to streamline the process of identifying these patients. This paper addresses ...


Reducing Delays In Follow-Up Care Through Process Optimization, Liam Malpass 2017 The University of San Francisco

Reducing Delays In Follow-Up Care Through Process Optimization, Liam Malpass

Master's Projects and Capstones

Primary care follow-up after an emergency department (ED) visit is an important component of comprehensive healthcare, contributing to both improved patient outcomes and reduced readmissions to emergency care. In alignment with the Clinical Nurse Leader (CNL) roles of risk anticipator and lateral integrator of care, this project aimed to support improvement in care continuity for patients at a large primary care clinic in London. At this clinic, a team of physicians, nurses, and support staff care for a diverse population of adult and pediatric patients who account for nearly 3,000 ED visits annually. Assessment of the clinical review process ...


Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan 2017 Washington State University College of Nursing in Vancouver

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of ...


Korean Sibling Caregivers Of Individuals Diagnosed With Schizophrenia, Mijung Park, Kwang-Ja Lee 2017 University of California, San Francisco

Korean Sibling Caregivers Of Individuals Diagnosed With Schizophrenia, Mijung Park, Kwang-Ja Lee

Asian/Pacific Island Nursing Journal

Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia.

Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1) diagnosed with schizophrenia and (2) hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives ...


Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman 2017 East Tennessee State University

Discharge Readiness For Families With A Premature Infant Living In Appalachia, Kathy Zimmerman

Electronic Theses and Dissertations

With increased advances in technology, the overall survival rates in the Neonatal Intensive Care Unit (NICU) for premature infants at lower gestational ages, has also increased. Although premature infants survive at lower gestational ages, they are often discharged to home with unresolved medical issues. While the birth of a new baby for parents is a joyous occasion, they often have difficulty coping and transitioning into a parental role. Premature infants also have ongoing complications such as difficulty with feeding, developmental delays in growth, and long-term eye and respiratory complications. As a result of chronic health sequelae, premature infants require extensive ...


A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker 2017 University of the Incarnate Word

A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker

Doctor of Nursing Practice

The purpose of this project was to improve statin therapy adherence among diabetic patients aged 65 and older treated at a small family practice clinic in western San Antonio. Additionally, the project aimed to decrease LDL cholesterol (LDL-C) levels in this patient population as recommended to 70 mg/dl or less. Diabetic patients are more likely to die from a cardiac event than patients without diabetes. Statin therapy is an important factor in lowering cholesterol, which reduces the patient’s risk for atherosclerosis. Educating patients aged 65 and older about the role of statin therapy in preventing cardiovascular events, stroke ...


Interventions To Increase Diabetes Self-Management Education Referral And Attendance, Genevieve Talamantez 2017 University of the Incarnate Word

Interventions To Increase Diabetes Self-Management Education Referral And Attendance, Genevieve Talamantez

Doctor of Nursing Practice

Despite the proven benefits of diabetes self-management education (DSME), referral and attendance remains suboptimal. DSME has the ability to encourage self-care behavior, improve clinical outcomes, and improve quality of life in a cost-effective manner. The American Diabetes Association recommends that all people with diabetes receive DSME in order to facilitate the knowledge, skills, and ability necessary for diabetic self-care. The Office of Disease Prevention and Health Promotion, Healthy People 2020, set a national diabetic patient education attendance target goal of 62.5% for adults. The purpose of this quality improvement project is to increase referral and attendance to DSME in ...


A Quality Improvement Initiative To Increase Hypertension Treatment Adherence Among Hispanic Patients With Limited English Proficiency, Barbara Chavez 2017 University of the Incarnate Word

A Quality Improvement Initiative To Increase Hypertension Treatment Adherence Among Hispanic Patients With Limited English Proficiency, Barbara Chavez

Doctor of Nursing Practice

The purpose of this project was to improve hypertension (HTN) treatment adherence among limited English proficient Hispanic patients with uncontrolled HTN. Limited English Proficiency (LEP) significantly reduces HTN control among Hispanics by diminishing their understanding of HTN diagnosis, treatment adherence, and complications. A language sensitive education session focusing on antihypertensive medications, reduced sodium intake, and appointment keeping was implemented among LEP Hispanic patients 21 to 85 years of age, with uncontrolled HTN, receiving care at a federally funded south San Antonio clinic. The Hill-Bone Compliance to High Blood Pressure Therapy Scale was utilized to measure adherence in the following domains ...


Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb 2017 University of the Incarnate Word

Improving Vaccination Rates In Adults With Type Ii Diabetes In A Family Practice Setting: An Evidence-Based Quality Improvement Project, Ronda Gottlieb

Doctor of Nursing Practice

The purpose of this evidenced-based quality improvement project is to implement processes to facilitate providers’ adherence to the American Diabetes Association (2017), American Association of Clinical Endocrinologist (2015), and American College of Endocrinology (2015) immunization guidelines for adults with type II diabetes. Presently, diabetes is the 7th leading cause of death in the United States contributing to serious complications throughout the body as a result of poor glucose control. Adults with diabetes are at increased susceptibility to infectious disease because of hyperglycemia, poor glucose control, and decreased immunity. A protocol was created using The Four Pillars Transformation Program ™ to align ...


Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson 2017 University of the Incarnate Word

Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson

Doctor of Nursing Practice

A dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health ...


Increasing Provider Awareness Of Patient Health Literacy Needs For Dental Screenings Among Patients With Diabetes In A Rural Health Clinic, Diana M. Solis 2017 University of the Incarnate Word.

Increasing Provider Awareness Of Patient Health Literacy Needs For Dental Screenings Among Patients With Diabetes In A Rural Health Clinic, Diana M. Solis

Doctor of Nursing Practice

The purpose of this project was to increase provider awareness of health literacy needs for recommended dental screenings among patients with diabetes in a rural clinic setting. Over 35% of adults in the United States are considered to have low literacy levels (Agency for Healthcare Research and Quality, 2015). Low health literacy levels have an impact on patient outcomes due to decrease compliance with recommended treatment plans and preventive health screenings. Patients with diabetes have a trifold increase of developing oral infections such as periodontal disease, fungal infections, and xerostomia (Kudiyirickal & Pappachan, 2015). Healthcare providers acknowledging a patient’s health ...


Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks 2017 University of Arkansas, Fayetteville

Influence Of Social And Economic Factors On Elementary Student Health In Northwest Arkansas, Megan Marks

The Eleanor Mann School of Nursing Undergraduate Honors Theses

A child’s wellbeing is influenced by many factors related to the environment they are raised in. The purpose of this study was to investigate the relationship between a child’s social and economic factors and his or her health. A convenience sample of 588 2nd and 4th grade children was taken from three elementary schools in Springdale Independent School District. Health status was represented by calculations of each child’s body mass index (BMI) and number of days counted absent from school. Socioeconomic and demographic factors examined include the child’s grade level, gender, ethnicity, number of parents over ...


Type 2 Diabetes Outcomes Resulting From Nurse Practitioner Utilization As A Primary Care Provider In Rural Communities, Chelsey Kamla 2017 DePaul University

Type 2 Diabetes Outcomes Resulting From Nurse Practitioner Utilization As A Primary Care Provider In Rural Communities, Chelsey Kamla

Grace Peterson Nursing Research Colloquium

Background: Type 2 diabetes mellitus is one of the most prevalent, preventable metabolic disorders our nation faces today. 29.1 million Americans or 9.3% of the U.S. population is diagnosed with diabetes, and the incidence of diabetes is approximately 17% higher in rural populations. Because of this, the nurse practitioner (NP) role is being increasingly utilized to provide quality, affordable primary care to offset physician shortage in rural communities and improve diabetes outcomes.

Objectives: This research works to answer how utilization of the nurse practitioner as a primary care provider has affected the outcomes of type 2 diabetes ...


Pots: Educating School Nurses, Stephanie Sherwood 2017 Liberty University

Pots: Educating School Nurses, Stephanie Sherwood

Graduate Student Projects and Scholarship

The project used educational modules as a means for providing knowledge about postural orthostatic tachycardia (POTS) to school nurses. It evaluated knowledge of symptoms and the referral process. A pre and post-test were used immediately prior to and following an educational module to determine gained knowledge about POTS. Participants completed a survey evaluating their perceived knowledge and comfort level to evaluate POTS symptoms and refer patients for further evaluation. One hundred percent of participants demonstrated improvement in their post-test score confirming knowledge gained in all participants. All participants reported that the modules helped them about POTS, and they felt confident ...


Clustering Diabetes Appointments And Education, April Pugh 2017 Liberty University

Clustering Diabetes Appointments And Education, April Pugh

Graduate Student Projects and Scholarship

Diabetes impacts the lives of millions of Americans, and the number is growing rapidly every year. Diabetes education has been demonstrated to have a positive impact of the self-management of this chronic disease and effective in the reduction of A1C, weight, and blood pressure. Barriers to attendance at both diabetes education classes and provider appointments are varied with lack of transportation and available time cited as two of the many reasons, especially in the rural and medically underserved regions of the country. The project assessed a process improvement intervention clustering diabetes education with provider appointments to increase attendance and decrease ...


Educational Intervention To Improve Self-Efficacy And Self-Care In Patients With Heart Failure, Helen Parke 2017 Liberty University

Educational Intervention To Improve Self-Efficacy And Self-Care In Patients With Heart Failure, Helen Parke

Graduate Student Projects and Scholarship

Heart failure is a high mortality, chronic disease that is economically and physiologically costly for patients, caregivers, and society. Heart failure teaching alone is insufficient in meeting the complex self-care needs of the heart failure patient. This project implemented evidence-based teaching methods that are skill-based and problem-solving based to educate heart failure patients in an outpatient setting. The theoretical foundation of this project was Bandura’s theory of self-efficacy and Orem’s theory of self-care. The level of self-care and self-efficacy was assessed before and after the multi-sensory teaching intervention. Self-care and self-efficacy have been studied and shown to be ...


Factors That Influence Intrinsic Motivation On Program Completion For Rehabilitative Patients: An Integrative Review Of Literature, Zareen Khan, Akif Khan 2017 DePaul University

Factors That Influence Intrinsic Motivation On Program Completion For Rehabilitative Patients: An Integrative Review Of Literature, Zareen Khan, Akif Khan

Grace Peterson Nursing Research Colloquium

Abstract

Background: Rehabilitation is often focused on improving an individual’s physical or functional capabilities after a traumatic injury. However, successful rehabilitation adherence and program completion has shown to have attributes of intrinsic motivation. Intrinsic motivation, as defined by Deci and Ryan (1985), is a learned behavioral trait that is driven by an internal force and produces a rewarding outcome.

Objectives: The purpose of an integrative literature review was to determine which factors influence intrinsic motivation among patients enrolled in rehabilitation programs. Thus, advancing the knowledge of clinicians to explore and utilize its applications with their clients; ultimately aiding them ...


Early Life Antibiotic Exposure And Its Association With Overweight/Obesity: An Integrative Review Of The Literature, Margaret Pfaff 2017 DePaul University

Early Life Antibiotic Exposure And Its Association With Overweight/Obesity: An Integrative Review Of The Literature, Margaret Pfaff

Grace Peterson Nursing Research Colloquium

Early Life Antibiotic Exposure and its Association with Overweight/Obesity: An Integrative Review of the Literature

Margaret Pfaff

Faculty Sponsor: Dr. Shannon Simonovich

Background: Prevention of or treatment for obesity could improve quality of life for many people. Infancy may be a critical period during which efforts should be focused to mitigate modifiable factors that may influence the risk for developing obesity.

Objectives: This integrative literature identified factors associated with greater incidence or effects of antibiotic exposure during infancy and examined the connection between early life antibiotic exposure and later in life overweight/obesity.

Method: This analysis followed the Whittemore ...


Rates Of Autoimmune Disease Increasing In Women, Rosa de la Cotera 2017 DePaul University

Rates Of Autoimmune Disease Increasing In Women, Rosa De La Cotera

Grace Peterson Nursing Research Colloquium

Abstract

Autoimmune disorders (AD) are a group of highly disabling pathological conditions that are growing at an alarming rate affecting approximately 8% of the population. These disorders occur more frequently in women, as 78% of those diagnosed are women. Little conclusive research has been conducted as to determine why there is a tremendous sex disparity when looking at the rates. Due to the overall poor health that results from these disorders, there is an increase in the societal burden in terms of health care costs, loss of work productivity and reduced quality of life. The aim of this integrative literature ...


Resilience And Coping In The Adolescent And Young Adult With Type 1 Diabetes, Debra L. Messinger 2017 Seton Hall University

Resilience And Coping In The Adolescent And Young Adult With Type 1 Diabetes, Debra L. Messinger

Seton Hall University Dissertations and Theses (ETDs)

There is a need to understand the roles coping strategies play in enhancing resilience in adolescents and young adults with type 1 diabetes between the ages of 18-30. The purpose of this study was to examine the relationships between and among positive, protective coping strategies (courageous coping), negative coping strategies (defensive coping), and resilience. The Resilience in Illness Model (Haase, Kinter, Monahan, & Robb, 2014) was the theoretical model which guided this research.

A convenience sample was recruited via diabetes organizations’ Facebook and Forum pages, a College Diabetes Network chapter meeting, and Juvenile Diabetes Research Foundations’ (JDRF) sponsored events. Data were ...


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