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A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley 2016 A DNP- FNP student graduating on May 19th, 2016

A Quality Improvement Project On Diagnosis And Management Of Asthma In A Private Pediatric Setting., Sosamma Ashley

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Although national guidelines exist for the diagnosis and management of asthma, general practice differs significantly from recommendations. Quality improvement methodology when implemented can narrow quality gaps.

Objective: The objective of the project was to create and implement a plan of action to address identified gaps in key clinical activities of asthma care among pediatric population in a private pediatric setting in Northern California

Methods: The project was centered on the use of Education in Quality Improvement for Pediatric Practice (EQIPP), a program of the American Academy of the Pediatrics. Both the pediatrician and the DNP student took this ...


Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller 2016 University of San Francisco

Reducing Iv Infiltrates In The Neonatal Population, Stephanie L. Miller

Master's Projects

Abstract

The objective of the CNL project is to improve the quality of care provided to our patients. The project focuses efforts to reduce IV infiltrates by auditing all running IV lines, IV management monitoring and auditing infiltrate grading and documentation to find commonalities that could be causing infiltrates.

The project is focusing on the neonatal population at a children’s hospital in the Neonatal Intensive Care Unit (NICU). This NICU is an 80 bed unit that houses both critical care patients and intermediate care neonates.

Auditing was a major component to the project and helped with identifying common causes ...


Obstetric Triage Improvement, Whitney DePaoli 2016 University of San Francisco

Obstetric Triage Improvement, Whitney Depaoli

Master's Projects

The objective of the obstetric triage improvement project is to decrease the average length of stay for perinatal patients presenting to the obstetric triage. The setting is a university hospital in a large urban city. The population includes pregnant patients with obstetric complaints presenting to triage for further evaluation. Methods used include a root cause analysis, process mapping, lean transformation methodology, and standardization of workflow. The results of the project include reducing the average length of stay in obstetric triage from a baseline of 152 minutes to 120.58 minutes, which represents a 21% decrease. The creation of standard workflows ...


Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips 2016 East Tennessee State Universtiy

Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips

Electronic Theses and Dissertations

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee ...


Doulas Could Improve Foreign-Born Women’S Perinatal And Postpartum Satisfaction And Increase Health Providers’ Cultural Competency In A Multicultural Urban Area Of The United States., Crystal Kazik 2016 Clark University

Doulas Could Improve Foreign-Born Women’S Perinatal And Postpartum Satisfaction And Increase Health Providers’ Cultural Competency In A Multicultural Urban Area Of The United States., Crystal Kazik

International Development, Community and Environment (IDCE)

Doulas act as a cultural bridge between clients and providers through the support, advocacy, and education they provide. Unfortunately, migrant women may be at a disadvantage for accessing and benefiting from their services due to a variety of socioeconomic and cultural factors including predisposed ideas of care and structure based on experiences in native countries, language barriers, lower health literacy, and a lack of awareness and understanding from hospital/clinic staff.

A strategic multifaceted approach utilizing doulas, such as Boston Medical Center’s collaborative and culturally competent model, may greatly improve foreign-born women’s experience and satisfaction with healthcare when ...


Therapeutic Listening Communication In Children With Autism And Hyperacusis, Jennifer Margaret Hughes 2016 California State University, Northern California Consortium Doctor of Nursing Practice

Therapeutic Listening Communication In Children With Autism And Hyperacusis, Jennifer Margaret Hughes

Doctoral Projects

Hyperacusis, or auditory hypersensitivity, is defined as abnormally sensitive hearing and in some cases an extreme sensitivity, where normally tolerated sounds are perceived as excessively, even painfully loud. This is a debilitating condition for children with autism, causing activity limitations and participation restrictions, also leading to peer isolation and habitual sound avoidance behaviors.

This research explores a means of modifying the auditory environment of a child with hyperacusis in a safe, effective way for the purpose of improving attention span and facilitating learning. The small pilot study (n=4) was a single-subject, multiple-baseline design, conducted with school-aged children in the ...


Breast Milk Exposure And The Incidence Of Necrotizing Enterocolitis In Very Low Birth Weight Pre-Term Infants, Meaghan Sullivan 2016 University of Connecticut

Breast Milk Exposure And The Incidence Of Necrotizing Enterocolitis In Very Low Birth Weight Pre-Term Infants, Meaghan Sullivan

Honors Scholar Theses

Purpose: To determine what degree of exposure to breast milk feeding is protective against Necrotizing Enterocolitis (NEC) in very low birthweight (VLBW) preterm infants.

Data Sources: This is a secondary data analysis of 56 VLBW preterm infants diagnosed with NEC and 56 age-matched VLBW infants who served as controls. All infants were born between 1997 and 2009 and cared for in the Newborn Intensive Care Unit (NICU). Infants were born at or before 29 weeks gestation and with a birth weight less than 1500 grams. Data included the volume fed daily and type of feeding along with demographic birth data ...


The Influence Of Socioeconomic Status And Ethnicity On Body Mass Index In Children In Northwest Arkansas, Madison E. Davidson 2016 University of Arkansas

The Influence Of Socioeconomic Status And Ethnicity On Body Mass Index In Children In Northwest Arkansas, Madison E. Davidson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a measure of body fat that is calculated based on the height, weight, age, and gender of a child. Body Mass Index (BMI) is an important indicator of potential health risks in children. Determining correlations between ethnicity, socioeconomic status, and BMI may assist in identifying children at risk for comorbidities associated with either an elevated or low BMI. An elevated BMI may lead to complications later in life such as hypertension, hyperlipidemia, type 2 diabetes, obesity in adulthood, and psychosocial issues (Geason & Dodd, 2009). On the other hand, a low BMI could lead to decreased ...


The Influence Of Birth Weight On Body Mass Index In Young Children In Northwest Arkansas, Margaret Frame 2016 University of Arkansas, Fayetteville

The Influence Of Birth Weight On Body Mass Index In Young Children In Northwest Arkansas, Margaret Frame

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a screening tool to measure body fat that is calculated based on the height, weight, age, and gender of a child. Being overweight as a child is defined as having a BMI between the 85th and 95th percentiles. Obesity is defined as having a BMI at or above the 95th percentile (“Basics About Childhood Obesity,” 2012). Having a high BMI comes with an increased risk of multiple co-morbidities, both physical and psychosocial (Pulgarón, 2013). Birth weight has been presumed to play a role in the prevalence of obesity in children. The purpose ...


The Presence Of Stem Cells In Human Breast Milk And Research Implications, Melody (Brooke) Peterson 2016 Liberty University

The Presence Of Stem Cells In Human Breast Milk And Research Implications, Melody (Brooke) Peterson

Senior Honors Theses

Stem cell therapy research is an expanding area of study as stem cell therapy is believed to have the potential to provide treatment options for numerous disease processes. Currently, embryonic stem cell research is the method of choice to evaluate the potential for stem cell therapy. The use of human embryos for stem cell research raises moral and ethical controversies. Stem cells are found in a variety of mediums, but until the recent discovery of stem cells in human breast milk, the most versatile stem cells have been those found in the human embryo. Human breast milk stem cells could ...


The Utilization Of Exogenous Surfactant In The Neonate, Katherine Thorkildsen 2016 Liberty University

The Utilization Of Exogenous Surfactant In The Neonate, Katherine Thorkildsen

Senior Honors Theses

Respiratory distress syndrome (RDS) is a common consequence of pulmonary immaturity in the lungs of neonates. RDS is the result of the deficient secretion of endogenous surfactant, causing increased surface tension in the alveolar sacs leading to respiratory compromise. RDS is more common in the preterm neonate but can be experienced by neonates at any gestational age. Treatment for RDS formerly consisted of mechanical ventilation and oxygen therapy to treat and relieve symptoms but not the cause. A new treatment method, developed largely in the 1980s and 90s is the use of exogenous surfactant to treat the deficiency exhibited in ...


Embryo Adoption As An Ethical Option For Couples Faced With Infertility, Rachel M. Walters 2016 Liberty University

Embryo Adoption As An Ethical Option For Couples Faced With Infertility, Rachel M. Walters

Senior Honors Theses

Embryo adoption takes embryos that are still forming and introduces them into the uterus of a woman with whom they do not share any genetic material. If pregnancy does ensue and continues without complications, the child that will be born will not share any genes with the woman who carried him or her. In addition, if the child is born to parents who already have other children, the children in the adoptive family will share no biological link to the newborn. Essentially, the child will have two families—a biological family and an adoptive family. This thesis will explore and ...


Training Traditional Birth Attendants In Sub-Saharan Africa, Lindsey J. Smith 2016 Liberty University

Training Traditional Birth Attendants In Sub-Saharan Africa, Lindsey J. Smith

Senior Honors Theses

Even after many adjustments, recommended practice regarding traditional birth attendants (TBAs) and their contribution to lowering the maternal mortality rate (MMR) continues to be disputed among various stakeholders. Sub-Saharan Africa continues to see high maternal mortality rates, despite various attempts by the World Health Organization (WHO) and others at utilizing the formal health care system (Prata, et al., 2011). Considering all factors and variables behind the reason for this problem in Sub-Saharan African, it is reasonable to conclude that training traditional birth attendants (TBAs) in evidence-based practice, in conjunction with developing longer-term strategies, is an appropriate approach for the short ...


Identifying Intimate Partner Violence During Pregnancy In Prenatal Care Settings, Tifani R. Fletcher, Andrea D. Clements, Beth Bailey 2016 East Tennessee State University

Identifying Intimate Partner Violence During Pregnancy In Prenatal Care Settings, Tifani R. Fletcher, Andrea D. Clements, Beth Bailey

International Journal of Health Sciences Education

More than 324,000 women each year are estimated as having experienced intimate partner violence (IPV) during pregnancy. Correctly identifying women experiencing all forms and severity of IPV is necessary to inform the implementation of interventions to prevent and treat IPV. This can optimally be accomplished with data from accurate screening instruments. The United States Preventative Services Task force has recently recommended that all women who are pregnant should be screened for IPV over the course of their pregnancy and postnatal visits. Currently, clinical practice and research are hindered by the lack of validated IPV screening measurements for a pregnant ...


A Systematic Review: Effects Of Breastfeeding On Early And Late Childhood, Kara Campbell, Samantha Fritz 2016 University of Akron

A Systematic Review: Effects Of Breastfeeding On Early And Late Childhood, Kara Campbell, Samantha Fritz

Honors Research Projects

Abstract

The topic of the long-term impact of breast milk and formula milk composition on the health status of children continues to be a focus of discussion and research. The aim of this systematic review is to describe and critically appraise current evidence regarding the lasting effects of breastfeeding on health outcomes in children throughout early and late childhood. Twenty-one studies focusing on infant feeding were identified using PubMed, CINAHL, and Medline databases. These studies were then categorized according to health outcomes such as: weight, developmental, and immune system effects. Through a critical appraisal of this evidence, it was found ...


Evaluation Of Nurses' Knowledge Of "Period Of Purple Crying" Program: Shaken Baby Syndrome Prevention, Cynthia L. Brubaker-Vincent BSN RN 2016 University of Kentucky

Evaluation Of Nurses' Knowledge Of "Period Of Purple Crying" Program: Shaken Baby Syndrome Prevention, Cynthia L. Brubaker-Vincent Bsn Rn

DNP Practice Inquiry Projects

Abstract

Shaken baby syndrome (SBS) and pediatric abusive head trauma (PAHT) continue to be the leading cause of child abuse death and most common causes of mortality and morbidity due to the physical child abuse in the United States (Barr, 2014). According to the CDC of the nearly 2,000 children who die from abuse each year, PAHT and SBS are responsible for 10-12% of those fatalities (CDC, 2015). There are 1450-1700 cases of reported shaken injuries to infants and children reported in the United States each year (Barr, 2014). Shaken Baby Syndrome is 100% preventable through the proper education ...


A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy 2016 University of Kentucky

A Study Of Provider Practices In The Screening, Diagnosis, And Treatment Of Childhood Overweight And Obesity In A Rural Eastern Kentucky Clinic, Ashley R. Healy

DNP Practice Inquiry Projects

Objectives: The purpose of this study is to assess the current practices of providers for overweight and obese children at well visits, and how the demographics of age, sex, race, ethnicity, primary language spoken, insurance type, and provider type influence the care provided to overweight and obese children at the study site, which is a rural primary care clinic in eastern Kentucky.

Methods: This study is a retrospective design auditing well child charts (n = 571) from the study site over a two year period. Charts were audited for the data points of age, sex, race, ethnicity, primary spoken language, body ...


A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer 2016 The University of Akron

A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer

Honors Research Projects

Due to multiple learning styles, it can be difficult to teach to large groups of students. The purpose of this study is to compare the effectiveness of two different educational interventions designed to teach infant hunger cues to undergraduate nursing students to increase the knowledge and confidence levels needed for the future teaching of infant hunger cues to new parents. Flemings VARK theory was used to guide this quasi-experimental study. A pretest posttest two-group design was used to evaluate both knowledge and confidence levels in the participants (N= 86). Data was analyzed utilizing a paired t-test. The results noted significant ...


The Effect Of Nurse Dose On Breastfeeding Exclusivity - A Patient Level Analysis, Gwen Moreland 2016 University of Kentucky

The Effect Of Nurse Dose On Breastfeeding Exclusivity - A Patient Level Analysis, Gwen Moreland

DNP Practice Inquiry Projects

Background: Breastfeeding is strongly associated with health benefits for children and their mothers. Despite this knowledge, breastfeeding rates in the United States have increased only slightly. Current research examines the relationship between nurse characteristics and patient outcomes in adult intensive care and acute care settings. To date there is very limited research examining nurse variables and outcomes in women and children, and very little knowledge regarding the characteristics of the nurse in relation to patient’s breastfeeding success.

Purpose: The purpose of this practice inquiry project was to evaluate the relationship between the attributes of nurse dose and the immediacy ...


An Examination Of Maternal Stress And Secondhand Smoke Exposure On Perinatal Smoking Status, Karen R. Damron 2016 University of Kentucky

An Examination Of Maternal Stress And Secondhand Smoke Exposure On Perinatal Smoking Status, Karen R. Damron

Theses and Dissertations--Nursing

The median prevalence of smoking among women of childbearing age in the United States is 22.4%. Of women who identify themselves as smokers in the three months prior to conception, 55% quit during pregnancy; however, 40% of those who quit relapse and return to smoking within six months after delivery. Smoking has been identified as an important means of stress management among smokers in general, and though limited to the perinatal period, pregnancy-specific stress adds to a woman’s typical day-to-day stress burden. Little data exists as to the effect of SHS exposure on smoking status during pregnancy and ...


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