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The Lived Experiences Of Icu, Med-Surg, And Er Nurses In The United States Attempting To Breastfeed During The Covid-19 Pandemic, Amy Seay

Dissertations

Breastfeeding is important to promote the health of both mothers and babies (Centers for Disease Control and Prevention [CDC], 2021). Many mothers experience workplace barriers and stress which negatively impact breastfeeding duration (McCardel & Padilla, 2020; Nagel et al., 2022). However, a gap in the literature exists surrounding specific barriers and the impact of stress on U.S. nurses who breastfeed. Specifically, workplace challenges and stress among nurses resulting from the COVID-19 pandemic lack exploration.

This interpretive phenomenological study explored the lived experiences of ICU, Med-Surg, and ER nurses who attempted to breastfeed during the COVID-19 pandemic. Roy’s adaptation model was …

Nursing Faculty Perceptions Of Stress, Coping, And Intent To Leave The Profession In The Ongoing Covid-19 Pandemic: A Quantitative Study, Lynlee Morgan

Dissertations

The COVID-19 pandemic impacted all of society to varying degrees; this impact was especially true in higher education due to an overnight transition to distance learning and incessant pivots to meet new guidelines and overcome obstacles. Nursing faculty were significantly impacted due to the responsibility of producing safe, qualified, competent practitioners to provide care in the clinical setting. The limitations in or exclusions from clinical experiences combined with the fact that faculty were managing personal concerns and had never encountered these unprecedented conditions exacerbated the challenge of preparing new nurses. This study was critical due to the faculty role and …

Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens

Doctoral Projects

Diabetes mellitus continues to grow in global prevalence and consumes an increasing amount of healthcare resources. Persons that live in disadvantaged groups have a higher prevalence due to a lack of understanding and access to care. Diabetes is one of the leading causes of chronic disease and limb loss worldwide. Diabetes foot care is essential, as diabetes can be dangerous to patients’ feet.

The purpose of this doctoral project was to increase diabetic foot care education and foot exams for staff and providers in a federally qualified health center (FQHC). Many people in this rural community do not understand the …

Chaos Is Not Rational: Nursing Leadership And Intuition In Disaster Preparedness And Response, Sarah Banks

Dissertations

Nurses are looked upon as leaders in disaster preparedness and response. Charged with making life-altering decisions, experienced nurse leaders utilize analytical and intuitive strategies to manage crisis situations. Rarely recognized by upper-level management and educational institutions, intuition is our natural ability to know something without any evidence or validation. Intuition allows us to make decisions in ever-changing circumstances when solutions are not obvious. Though difficult to explain, intuition is a powerful skill that gives nurse leaders the confidence needed to make decisions based on their previous experience. Experienced nurse leaders utilize intuition to arrive at a solution without conscious awareness …

Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre

Doctoral Projects

The opioid epidemic is affecting Mississippi’s young to middle-aged adult population in a profound way. Pharmacotherapy for opioid use disorder (OUD) is the gold standard treatment. Despite the FDA-approved evidence-based treatment of pharmacotherapy for OUD, rural areas often lack providers available who will initiate and provide maintenance of this life-saving medication. For this doctoral project, a 36-question survey was developed based on a preliminary literature review. The survey was disseminated to advanced practice registered nurses (APRNs) in the family and psychiatric specialties across Mississippi to assess the barriers to APRNs filling the gap in pharmacotherapy prescribing for OUD. A continuing …

Lateral Decubitus And Prone Positioning: An Objective Structured Clinical Evaluation, David Hesley-Hernandez, James Bailey

Doctoral Projects

Improper positioning of patients in the lateral decubitus or prone positions can lead to significant complications, including but not limited to: airway and invasive line loss, physiologic derangements, soft tissue injury, and peripheral nerve injuries (PNI) (Barash et al., 2017; Butterworth et al., 2018). Chui et al.’s (2018) analysis found that PNIs accounted for 12% of anesthesia malpractice since 1990, making PNIs costly. PNIs effects are not limited to cost and result in increased lengths of stay, increased pain levels, and decreased quality of life (Wojtkiewicz et al., 2015). The massive effect poor positioning can have requires that the anesthesia …

Objective Structured Clinical Examination For Intraoperative Hypotension And Hypertension Management, Andrew Mcginity, James David Ingram

Doctoral Projects

Managing intraoperative hypotension and hypertension is a non-technical skill anesthesia providers need to maintain patient safety. Upon transitioning from didactic training to clinical training, SRNAs may find it difficult to manage a patient’s blood pressure intraoperatively. The ultimate consequence of the delayed or improper treatment of intraoperative blood pressure perturbations is end-organ damage at the patient’s expense. Unintentionally causing a patient harm will lead to an SRNA losing confidence in their abilities. This OSCE is intended to increase SRNA confidence and competence regarding intraoperative hypotension and hypertension management before entering the clinical arena.

The hypotension and hypertension management tools and …

Does The Use Of Mental Health Screenings And Targeted Stress Interventions Improve Mental Health Outcomes In Outpatient Clinic Staff?, Mary Benson

Doctoral Projects

The Perceived Stress Scale (PSS) has been used as a classic stress assessment instrument to evaluate perceived stress across many settings. As stress is the primary phenomenon in this review due to varying stressors, including infectious diseases among healthcare workers, the PSS is the most appropriate scale for evaluating the degree to which a health worker feels stressed. In addition, the PSS is valuable as it encompasses ten items that researchers use to explore how respondents react to stress due to unpredictable events. Thus, this DNP project is based on the postulation that screening with the PSS and applying stress …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Amniotic Fluid Embolism During Cesarean Section: An Objective Structured Clinical Exam, Mackenzie Acosta, Morgan Self

Doctoral Projects

Amniotic Fluid Embolism is a rare obstetric event that has a high morbidity/mortality rate. It is imperative that the anesthesia provider be properly educated on how to recognize and treat an AFE. Prompt recognition and treatment, including the AOK regimen, increase the patient's chance of survival. The faculty for The University of Southern Mississippi’s Nurse Anesthesia Program acknowledged the need for an objective-based exam on Amniotic Fluid Embolism during the Cesarean section. The need for an educational tool on AFE prompted the creation of this doctoral project and resulted in an AFE OSCE which has been added to the OSCE …

Objective Structured Clinical Evaluation For Volume Control And Pressure Control Ventilator Modes, Brian Bailey, Anthony Newsom

Doctoral Projects

The purpose of this doctoral project was to create a tool to teach student registered nurse anesthetists (SRNAs) in The University of Sothern Mississippi’s (USM’s) anesthesia program about pressure control and volume control ventilator modes, and how to use them. To accomplish this goal an Objective Structured Clinical Examination (OSCE) was developed. The framework used for creating this OSCE was Kolb's Theory. Kolb's Theory uses a four-stage learning cycle in which the learner encounters a new experience, reflects on the observations of said new experience, conceptualizes or modifies a concept based on this experience, and then applies their idea to …

Implementing A Depression Screening Process Within A Primary Care Setting Initiative To Improve Quality Patient-Centered Healthcare, Mark Beech

Doctoral Projects

Depression is more widespread than many people understand. Depression is a common mental disorder involving millions of people from all backgrounds, races, and socioeconomic levels (World Health Organization [WHO], 2020). Depression not only affects one’s mental well-being but can be often linked to one’s physical well-being. Additionally, depression is often misdiagnosed and can many times go undetected. The stigma of depression or any mental health disorder still has many patients feeling shameful and the need to be secretive which can prevent proper treatment. The implementation of a depression screening process by utilizing a tool for early depression detection is essential …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

The Effects Of An Interprofessional Education Video On Dermatologists’ Understanding Of The Role Of The Dermatology Certified Nurse Practitioner, Danielle Elaine Spelich

Doctoral Projects

Dermatology-certified nurse practitioners (DCNPs) have validated knowledge of a dermatology core curriculum and have at least 3,000 hours of formal or informal dermatology training (Dermatology Nurse Practitioner Certification Board [DNPCB], n.d.a). With their standardized education and training, DCNPs are meeting the benchmarks set out by dermatologists. Subsequently, DCNPs have become the new gold standard for dermatology advanced practice registered nurses (APRNs).

However, there is no mention of DCNPs by the American Academy of Dermatology (American Academy of Dermatology [AAD], 2022), and personal experience with dermatologists is that they lack knowledge about DCNPs. This lack of knowledge could create an impasse …

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Examining P3 And N2 Amplitudes Following Social Exclusion And Provocation In College Students With High And Low Narcissistic Traits, Kathleen Ramsey

Dissertations

Adults with narcissistic traits are prone to reacting aggressively following provocation due to elevations in emotional reactivity and perceived threat to their grandiose self-views. Prior studies have examined event-related potentials (ERPs) measures in college students with narcissistic traits in the context of risky decision making and facial emotion processing; however, no known studies have examined how those with narcissistic traits react to rejection and provocation at the neurophysiological level during an externally valid social rejection task (i.e., Cyberball). For the purposes of this study, it was predicted that participants with higher levels of narcissistic traits (both total narcissism and grandiose …

Self-Compassion And Perceived Readiness For Practice Among Baccalaureate Nursing Students: A Mixed-Methods Study, Laurie A. Walter

Dissertations

There is increasing concern about how nursing students’ psychological health will impact their future nursing practice. The COVID-19 pandemic has enhanced these concerns. Nurse educators are being challenged with preparing nursing students to provide compassionate, patient-centered care despite the stress and psychological challenges of today’s healthcare environment. Self-compassion is a practice of mindfulness, self-kindness, and common humanity which positively influences and predicts psychological health. The purpose of this study was to explore the relationship between self-compassion and perceived readiness for professional practice among undergraduate nursing students.

A convergent mixed-method design utilizing correlational and directed content analyses explored this relationship. The …

Predictors Of Engagement In Nursing Professional Practice: Transforming Organizational Culture In The Post-Covid Healthcare Environment, Jennifer Garnand

Dissertations

Cultivating the shared belief that individuals matter within an organization enhances the empowerment of staff and supports enthusiastic engagement in organizational efforts aimed toward a common mission, vision, and goals (McShane & Von Glinow, 2019). The nursing profession has been plagued by an unprecedented decrease in engagement and diminished job satisfaction, particularly following the prolonged tenure of the COVID-19 pandemic, leading to subsequent attrition amidst a staffing crisis. This quantitative predictive correlational study seeks to determine whether proactive and persevering characteristics, professional identity, and passion of nurses are predictors of engagement in a post-COVID healthcare environment. The research was based …

An Investigation Of Anti-Intellectualism Among Nurses, Jamie Davis-Tubbs

Dissertations

Anti-intellectualism is often offered as an explanation for irrational actions, especially in the grips of uncertainty. The effects of the COVID-19 pandemic have uncovered the consequences of anti-intellectualism within the healthcare system. Nurses, the most identifiability trusted healthcare professionals, have been used to illustrate a healthcare paradox regarding COVID-19. The healthcare paradox presents nurses as highly trained healthcare professionals who do not believe in their own science and reject scientific expertise. Furthermore, nursing anti-intellectualism has been used to spread misinformation during a major health crisis. Yet, we do not know the depth in which anti-intellectualism exists within the nursing profession. …

Patient Portal Use And Patient Education Materials Access Among Mississippi Adult Residents, Anna K. Swann

Dissertations

Patient education plays a vital role in improving the health outcomes of patients with chronic diseases and helps prevent illness in otherwise healthy individuals. Patient portals allow patients to access their EHRs, communicate with their healthcare providers, and access patient education materials. Despite the potential for patient portals and education materials to improve health outcomes, many barriers prevent patients from utilizing them. Uneducated patients are more likely to participate in risky health behaviors, which leads to poor health outcomes. Poor health outcomes lead to higher medical costs. Mississippi has a high rate of chronic diseases. Suppose the barriers to patient …

Perceptions Of Perinatal Nurses Caring For Perceived Stigmatized Patients During The Covid-19 Pandemic In Perinatal Settings: A Qualitative Study, Deborah Tucker

Dissertations

Perinatal nursing consists of caring for women before, during, and shortly after the birth experience, providing a unique opportunity for nurses to care for women and families in a fundamental moment of life (Simpson et al., 2020). This qualitative descriptive study design allows for straight descriptions of phenomena to evaluate perceptions of nurses caring for perceived stigmatized patients in the perinatal setting during the SARS-CoV-2 (COVID-19) pandemic. As research gaps were identified, the following research questions were developed and used to guide this study:

1. What are the perceptions of caring in perinatal nurses who deliver care to perceived stigmatized …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

Decreasing Hospital Readmission With Post-Hospital Discharge Primary Care Clinic Appointments, David Snodgrass

Doctoral Projects

ABSTRACT

The Centers for Medicare and Medicaid Services (CMS) continue to apply costly financial penalties for hospital readmission. Hospital readmission can stem from multiple causes which can lead to poor health outcomes or increased healthcare financial costs. However, with the use of an implemented 14-day post-hospital follow-up appointment with a primary care provider, hospital readmission could be reduced, and patient care improved. The multiple factors that can lead to hospital readmission include non-adherence to medication, socioeconomic factors, patient-related factors, condition-related factors, or health system-related factors. Through the implementation of post-hospital discharge follow-up visits within 14 days of discharge, hospital readmissions …

The Impact Of Social Determinants Of Health On Hypertension, Lakenya Forthner

Doctoral Projects

ABSTRACT

Nearly 43% of African American men have Hypertension (HTN). HTN is a major reversible health problem for young adult, African American males. Identifying health behaviors to enhance longevity is essential due to the “excess burden of preventable, chronic diseases and premature death among African American men. The “role of social determinants of health (SDOH) on outcomes, and the possible role these determinants play in disparities have largely been ignored” (Haggart, 2018, pp. 2, 8).

Interventions that address SDOH must take a multicomponent approach. Evidence has been established that adhering to a healthy lifestyle reduces the burdens and risks associated …

A Quality Improvement Project: Streamlining The Post-Surgical Process In Total Knee And Hip Replacements With An Evidence-Based Guidance And Practice Protocol, Bianca Bullie

Doctoral Projects

ABSTRACT

The rates of total joint replacements, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA), are on the rise in the United States and are expected to rise further in the next 20 years (Singh et al., 2019). Implementing an ERAS protocol coupled with current orthopedic practices will decrease a vast number of postoperative issues such as length of hospital stays, the financial burden on the facility, and overall patient satisfaction. The DNP project proposed a multidisciplinary protocol to standardize the care of patients undergoing THA or TKA and identified if this surgical process would be adopted …

Improving Compliance With Treatments For End-Stage Renal Disease Patients On Hemodialysis, Susan Blakeney

Doctoral Projects

According to Blumrosen et al. (2020), the dialysis population cost expenditure is greater than “seven percent of the Medicare budget at nearly $40 billion a year” even though this population is “less than one percent of the Medicare population” (p. 1436). Additionally, the renal disease population is growing in the United States and internationally which contributes to rising healthcare costs around the globe (Levin, 2018).

The purpose of this Doctor of Nursing Practice (DNP) project was to identify the factors or reasons hemodialysis patients miss treatments or only stay for partial treatment. Hemodialysis patients are required to have treatments three …

The Knowledge And Attitudes Of Oncology Nurses On Advance Directives, Bailey Nettles

Dissertations

Advances in healthcare technology has changed how healthcare professionals care for patients, increasing the importance of Advance Directives (ADs). ADs are legal documents describing patient end-of-life care wishes. Despite the usefulness of ADs, particularly in oncology settings, most patients do not have one.

This qualitative content analysis study examined knowledge and attitudes of ADs among oncology nurses to obtain a better understanding of ADs. Literature on ADs and nurses is dominated by quantitative research. This study addresses knowledge gaps best filled by qualitative methods.

Ten experienced oncology nurses answered eleven open-ended questions using online video conference interviews. The eleven questions …