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Examining A Fatigue Management Model That Identifies Risk Factors And Consequences Of Fatigue In Older Individuals, Maral Torossian
Examining A Fatigue Management Model That Identifies Risk Factors And Consequences Of Fatigue In Older Individuals, Maral Torossian
Doctoral Dissertations
Fatigue is experienced by 40-74% of older individuals living with a chronic disease. Despite advances in scientific knowledge around risk factors and consequences associated with fatigue, a comprehensive model that can serve as a guide for healthcare providers caring for older individuals with fatigue is lacking. Thus, the purpose of this study was to examine a fatigue model based on the Theory of Unpleasant Symptoms (TUS). The model included psychological, physiological, and situational risk factors of fatigue, as well as fatigue outcomes, such as physical, social, and cognitive performances, perceived health, and quality of life (QOL). This was a secondary …
A Cloud Infrastructure For Large Scale Health Monitoring In Older Adult Care Facilities, Uchechukwu Gabriel David
A Cloud Infrastructure For Large Scale Health Monitoring In Older Adult Care Facilities, Uchechukwu Gabriel David
Masters Theses
Technology development in the sub-field of older adult care has always been on the back-burner compared to other healthcare areas. But with increasing life expectancy, this is poised to change. With the increasing older adult population, the current older adult care facilities and personnel are struggling to keep up with demand. Research conducted in the Netherlands [1] found 33,000 older adults were awaiting admission into a home for the elderly showing that demand far exceeds availability. This huge demand for older adult care has resulted in a decrease in the quality of care being provided. A recent study involving older …
Perseverance: A Focused Ethnographic Study Of The Emergency Triage Nurse, Ellen C. Smithline
Perseverance: A Focused Ethnographic Study Of The Emergency Triage Nurse, Ellen C. Smithline
Doctoral Dissertations
Introduction: The emergency triage process is not meeting the needs of the patient or the healthcare team. Current and past research has focused primarily on the emergency triage nurse’s ability to accurately designate the triage acuity score, while largely ignoring the impacts of the complex and dynamic environment in which they are immersed. Therefore, the purpose of this study was to describe the factors that influence the decision-making process of the emergency triage nurse (ETN). Method: This was a focused ethnographic study that included four phases. Phase 1 was the grand tour of the emergency triage and waiting room area. …
Nurse-Delivered Shoe-Lacing Intervention: Effect On Comfort And Toe Pressures For Active Community-Dwelling Adults (Age 65+), Mary C. Clayton-Jones
Nurse-Delivered Shoe-Lacing Intervention: Effect On Comfort And Toe Pressures For Active Community-Dwelling Adults (Age 65+), Mary C. Clayton-Jones
Doctoral Dissertations
Significance: Problems with shoe fit are endemic, affect gait and balance and lead to falls. Falls are physically, emotionally, and economically costly. Low-cost, easily implemented interventions, that reduce pain and improve balance meet the “triple aim” of the Institute for Healthcare Improvement. Purpose: Evaluate the impact on community-dwelling adults (65+) of two nursing interventions involving foot repositioning and shoe relacing. Outcome measures: Toe pressures, experiences of pain and comfort. Method: Repeated-measures, mixed-methods lab-based study. Walk #1 Control. Intervention #1, participant’s heel secured to back of shoe, the participant’s chosen lacing pattern snugged. Intervention #2, heel secured to back of …
Hospital Assessment And Response To Environmental Pollution As A Population Health Need: Identifying Prevalence And Predictors In Community Benefit Practices, Sarah Valentine
Doctoral Dissertations
Hospitals have a growing role in improving population health. Environmental pollution is an important determinant of health with disproportionate effects on Communities of Color. This warrants hospital action. To advance such action, it is important to take stock of current hospital engagement with environmental pollution and to identify factors associated with such engagement. I investigated the following. To what extent do New York State (NYS) non-profit hospitals assess, identify, and respond to environmental pollutants as part of community benefit practices? Do factors previously reported as associated with hospital engagement of social determinants predict engagement with environmental pollution as a community …
A Quality Improvement Project For Opioid Use Disorder At A Psychiatric Hospital In Western Massachusetts, Pauline T. Eteng
A Quality Improvement Project For Opioid Use Disorder At A Psychiatric Hospital In Western Massachusetts, Pauline T. Eteng
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Opioid abuse is a challenging health care concern, and has been identified as a national public health issue. The prevalence of illicit fentanyl and prescription pain medication in our society are related to a multitude of factors which have impacted many lives and triggered a national epidemic despite experts' preventative measures and treatment recommendations. Purpose: A quality improvement (QI) project was designed to enhance the assessment of patients suffering from opioid use disorder (OUD) with evidence-based screening tools to prevent opioid abuse among adult patients in a chronic care psychiatric hospital. Methods: The QI project integrated …
Improving The Frequency And Efficacy Of Advance Care Planning In Primary Care, Katherine Farrell
Improving The Frequency And Efficacy Of Advance Care Planning In Primary Care, Katherine Farrell
Doctor of Nursing Practice (DNP) Projects
Background: Advance care planning (ACP) is a process to support patients in understanding and expressing their future medical wishes. Despite evidence supporting the benefits of ACP there remain a number of barriers limiting uptake of this important practice. Absence of advance care planning places patients at risk of receiving care misaligned with their values, goals, and preferences as well as increased patient and family distress at end-of-life. Purpose: This quality improvement (QI) project addressed provider knowledge, and patient awareness and level of engagement in the advance care planning process in an effort to increase the frequency and efficacy of ACP …
A Toolkit To Assist Child And Adolescent Providers In Assessing Problematic Internet Use And Cyberbullying In An Outpatient Psychiatry Clinic, Collin J. Mcgrath
A Toolkit To Assist Child And Adolescent Providers In Assessing Problematic Internet Use And Cyberbullying In An Outpatient Psychiatry Clinic, Collin J. Mcgrath
Doctor of Nursing Practice (DNP) Projects
Social media has become a transformational part of daily life in the United States. Currently, there are few assessment tools and no standard of care when it comes to assessing internet use, social media, and cyberbullying among child and adolescent patients. Problematic internet use (PIU) and cyberbullying can both significantly and negatively impact the mental health of children and adolescents. The purpose of this project is to evaluate the effectiveness of an online toolkit implementation for a Southwest Florida (SWFL) outpatient psychiatry office. A pre/post one group design was used. A convenience sample of 13 healthcare providers was recruited from …
Evidence-Based Strategies For The Prevention Of Workplace Violence Against Health Care Workers: Creating An Educational Toolkit, Chibuzor Anyanwu
Evidence-Based Strategies For The Prevention Of Workplace Violence Against Health Care Workers: Creating An Educational Toolkit, Chibuzor Anyanwu
Doctor of Nursing Practice (DNP) Projects
Background: Violence in healthcare is a growing problem. Health care workers are being physically and psychologically assaulted by patients and their families. This is particularly a problem in emergency departments, psychiatric units, waiting rooms and geriatric facilities.
Purpose: This project focused on the creation of an educational toolkit for the prevention of violence against healthcare workers.
Methods: This quality improvement project used Kotter’s 8-step change model to guide the evaluation of a toolkit incorporating evidence-based nonviolent crisis prevention strategies with Crisis Prevention Institute’s top 10 de-escalation tips. The project was implemented at a psychiatric hospital in Illinois. Healthcare workers reviewed …
Increasing Knowledge And Awareness Of Expedited Partner Therapy Among Providers, Angeline K. Motari Mokaya
Increasing Knowledge And Awareness Of Expedited Partner Therapy Among Providers, Angeline K. Motari Mokaya
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: In the past six years, there has been a steady rise in the number of reported cases of chlamydia and gonorrhea in the United States. Expedited partner therapy (EPT) refers to the practice of treating partners of patients diagnosed with specific treatable sexually transmitted infections without first evaluating them. This treatment was recommended by the Centers for Disease Control and Prevention in 2006 and it is currently legalized in 45 states and the District of Columbia. However, many health care providers (HCPs) do not have knowledge of EPT therefore do not make use of it.
Purpose: This quality …
Implementing An Interactive Educational Intervention To Increase Knowledge On Phosphorus Diet And Binder Adherence In Patients Receiving Hemodialysis, Rene Chagnon
Doctor of Nursing Practice (DNP) Projects
Background: Maintaining low serum phosphorus (PO4) levels is recommended in patients receiving hemodialysis through a low phosphorus diet and binder medication compliance, however this remains a struggle for many patients. The literature shows that educational interventions focused on phosphate management can increase patients’ knowledge and improve patient outcomes.
Purpose: To implement an educational intervention focused on low phosphorus diet and adherence to binder regimen to increase patients’ knowledge base, receiving hemodialysis at an outpatient unit at a Veterans Affairs (VA) Hospital.
Methods: An interactive educational intervention involving two 30-minute, one-to-one counseling sessions with educational materials including short videos and a …
Identification Of Post-Intensive Care Syndrome (Pics) In Primary Care, Danielle L. Riggi
Identification Of Post-Intensive Care Syndrome (Pics) In Primary Care, Danielle L. Riggi
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Post-intensive care syndrome (PICS) occurs in approximately 50% of ICU survivors and increases risk of mortality and hospital readmission while decreasing quality of life. There were no national guidelines for diagnosis or treatment of PICS at the time of the completion of this project.
Purpose: The purpose of this project was to increase identification of PICS in the primary care setting by providers. This was accomplished by implementing an educational toolkit and algorithm to better identify patients with PICS and to evaluate the incidence of PICS.
Methods: An educational presentation and a survey were presented to the providers …
Elearning Module For Nursing Students To Improve Delirium Identification, Prevention, And Management, Shannon Baker
Elearning Module For Nursing Students To Improve Delirium Identification, Prevention, And Management, Shannon Baker
Doctor of Nursing Practice (DNP) Projects
Background and Review of Literature: Delirium is a serious, acute alteration in cognition and consciousness, which is common amongst older hospitalized patients and has an overwhelmingly negative impact on patient outcomes. Under-recognition by healthcare providers poses a barrier and contributes to poor patient outcomes, including increased morbidity and mortality.
Purpose: To reduce the incidence of delirium amongst acutely ill patients via internet-based education for student nurses on delirium prevention, assessment, and management.
Methods: An eLearning intervention consisting of a virtual lecture with an unfolding case study for undergraduate nursing students. This project utilized the Nurses’ Delirium Knowledge Assessment (NDKA) …
Massage Therapy For Anxiety And Depression, R. Maryam Lempke
Massage Therapy For Anxiety And Depression, R. Maryam Lempke
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Massage therapy is a proven method for reducing symptoms of anxiety and depression as evidenced through literature review. However, the practice of complementary and integrative modalities (CIM), such as massage, is uncommon within psychiatric care. This leaves a gap in practice in the psychiatric setting. Purpose: The capstone quality improvement project addressed the identified gap by providing education on massage therapy to mental health providers and clients, and by increasing massage accessibility and use in the outpatient psychiatric setting by providing education on performing self-massage. Methods: The education was provided via pre-recorded video. Clients/providers completed pre and post-assessments …
A Quality Improvement Project To Assess The Value Of Pharmacogenomic Testing In Adults Diagnosed With Major Depression, Ileana Miranda Velazquez
A Quality Improvement Project To Assess The Value Of Pharmacogenomic Testing In Adults Diagnosed With Major Depression, Ileana Miranda Velazquez
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Treatment of major depression follows the guidelines from evidence-based medicine established algorithms; however, 50% of patients diagnosed with major depressive disorder do not respond to their first medication trial, and 70% may go through four treatment attempts before achieving remission.
Purpose: To demonstrate the value of pharmacogenomic testing as a treatment-guidance technology in patients with resistant depression and assess healthcare providers' motivation to adopt the technology.
Methods: A retrospective chart review of (N = 73) patients' treatment response measured by the pre-post PHQ-9 depression scale after pharmacogenomic guided medication intervention with descriptive statistics and paired t-test. The …
Educating Nurse Practitioners On Aces And The Hope Model To Improve Awareness And Acceptability Of Trauma-Informed Care, Emily T. Gardner
Educating Nurse Practitioners On Aces And The Hope Model To Improve Awareness And Acceptability Of Trauma-Informed Care, Emily T. Gardner
Doctor of Nursing Practice (DNP) Projects
Background: Adverse childhood experiences (ACEs) continue to demonstrate negative effects on children and adults’ health. A dose-response relationship exists between the number of adverse experiences a person faces during childhood, and the extent and severity of chronic illnesses developed in adulthood, including early death. Identifying patients who have ACEs is key to managing their health care. Trauma-informed care provides a clinical framework in which patients with a history of ACEs receive optimal health care to prevent and manage the health influences of ACEs.
Purpose: The purpose of this Quality Improvement (QI) project was to increase nurse practitioner (NP) knowledge about …
Increasing Enrollment Of Cardiac Rehabilitation For Eligible Patients In The Outpatient Setting: A Toolkit, Staci M. Grothues
Increasing Enrollment Of Cardiac Rehabilitation For Eligible Patients In The Outpatient Setting: A Toolkit, Staci M. Grothues
Doctor of Nursing Practice (DNP) Projects
Background: Heart disease is the leading cause of death worldwide. It is responsible for serious cardiac events that can be fatal. When a patient experiences one cardiac event, they are more likely to have a second event. Therefore, secondary prevention programs such as cardiac rehabilitation (CR) have been proven to reduce mortality in these patients and enhance quality of life; however, they are severely underutilized. Purpose: The purpose of this integrative review and DNP project was to educate outpatient providers about the immense value of cardiac rehabilitation to eligible patients and develop a toolkit targeted to help providers recognize eligible …
Educating Primary Care Providers In Dual Diagnosis Disorders Of Mental Health And Substance Use, Sarah Stout
Educating Primary Care Providers In Dual Diagnosis Disorders Of Mental Health And Substance Use, Sarah Stout
Doctor of Nursing Practice (DNP) Projects
Abstract
Purpose: Many adults in the United States suffer from mental health and substance use disorders. Due to personal and structural barriers, care is not always received by those who suffer with a dual diagnosis. Lack of education among primary care healthcare providers is a barrier to dual diagnosis treatment. The aim of this project was to present and summarize evidence to increase the providers knowledge, assessment, and confidence levels in treatment of these disorders. Methods: This project was designed using a quality improvement (QI) approach to increase the knowledge, and confidence of primary care healthcare providers through an educational …
Telehealth Coaching To Improve Exercise Self-Efficacy In Diabetics, Oby C. Ikoro
Telehealth Coaching To Improve Exercise Self-Efficacy In Diabetics, Oby C. Ikoro
Doctor of Nursing Practice (DNP) Projects
Abstract
Background and Review of Literature: Exercise is essential to the self-management of Type 2 Diabetes Mellitus (T2DM). The literature reveals that many patients with difficulty in the self-management of exercise improve with coaching. The literature also reveals that an adequate exercise routine results in improved blood glucose control and the prevention of complications.
Purpose: This DNP project aims to demonstrate the positive effect of low-cost telehealth coaching to improve self-efficacy in an exercise regimen for T2DM patients.
Methods: A one-group pretest-posttest design was used in this project. Telephone calls and text messaging were used to coach patients to improve …
Noteaid: A Comprehension Tool To Improve Patient Understanding, Harriette F. Green
Noteaid: A Comprehension Tool To Improve Patient Understanding, Harriette F. Green
Doctor of Nursing Practice (DNP) Projects
Background: Meaningful use mandates allow patients access to provider notes, however, there remain many barriers including the inability of the patient to understand the notes.
This project surveyed clinicians on the informatics committee of a large tertiary care facility about their thoughts regarding the Noteaid translation system after presenting examples of translated patient notes and education about the meaningful use mandate.
Methods: An online PowerPoint presentation and preintervention survey was distributed, followed by a live educational intervention. The members were emailed a post intervention survey about the effectiveness, likeability, usability, and practicality of the Noteaid software tool to translate …
The Importance Of Understanding Military Culture In Delivering Mental Health Care To Veterans: An Educational Intervention And Toolkit To Inform And Assist Civilian Providers, Ashlee M. Costa
Doctor of Nursing Practice (DNP) Projects
Abstract
Background and Review of Literature: United States Veterans are a unique population of individuals who require specialized mental health care. A review of literature revealed the Veteran population is primarily treated by civilian providers in the community who are often unaware of the impact of military culture on Veterans. Since this lack of awareness can be very disruptive to treatment and ultimately to the healing process, there is a need for advocacy related to the cultural ramifications of military service. Purpose: The DNP project goal was to increase civilian provider knowledge of the Veteran’s experience. Method: The …
Development Of A Pediatric Depression Healthcare Toolkit, Maria Theresa Kennedy
Development Of A Pediatric Depression Healthcare Toolkit, Maria Theresa Kennedy
Doctor of Nursing Practice (DNP) Projects
Background: Depression is a debilitating and life-threatening disease that strongly affects youth in the United States. Low socioeconomic populations often have high-risk factors for depression, low health literacy, and poor access to care. Risk factors are amplified for those who identify as gender non-binary or lesbian, gay, bisexual, transgender, or queer (LGBTQ). Psychoeducation can empower youth to be active participants within their treatment.
Purpose: The focus of this project was to evaluate a newly developed healthcare toolkit for pediatric depression in the format of an eBook for mental health professionals.
Methods: An eBook focusing on depression pathology, symptoms and …
Parenting Group For Externalizing Youth With Side Benefits For Parents, Diane Johnson
Parenting Group For Externalizing Youth With Side Benefits For Parents, Diane Johnson
Doctor of Nursing Practice (DNP) Projects
Abstract
Background/Purpose: Mental health problems in the form of externalizing behaviors in children continues to climb. The financial burden, along and increased risks of long-term adverse effects, are a critical area that are improved with interventions such as parent management training (PMT). PMT is an evidence-based treatment for disruptive and externalizing child behaviors. Even brief interventions can improve parents’ perceptions of challenging behavior and benefit parental well-being through stress reduction and self-efficacy. Purpose: To provide PMT concepts through a group format and improve parental perceptions of externalizing behaviors and stress reduction. Methods: Provide a six-session parent group with discussion, video, …
Mind Your Mama! Addressing Implicit Bias, Racism, Antiracism, And Reproductive Justice With Healthcare Providers To Improve Maternal Outcomes, Caroline Toby
Doctor of Nursing Practice (DNP) Projects
Background: Maternal health care providers’ implicit racial biases affect quality of care and have serious repercussions, including significantly increased rates of maternal mortality among Black women. Implicit bias training, particularly involving multipronged approaches stretched over time, is effective at increasing bias awareness and gaining practical skills to prevent bias from impacting patient care. Purpose: The purpose of this quality improvement project was to elevate implicit bias awareness and use of evidence-based strategies by resident physicians in order to decrease negative outcomes for Black women receiving maternity care. Methods: An educational intervention was implemented with obstetrics and gynecological residents in a …
An Educational Intervention For New Graduate Nurses To Improve Care For The Hospitalized Patient With Diabetes, Elizabeth Tinios
An Educational Intervention For New Graduate Nurses To Improve Care For The Hospitalized Patient With Diabetes, Elizabeth Tinios
Doctor of Nursing Practice (DNP) Projects
Background: Approximately one in three hospitalized patients have a diagnosis of Diabetes Mellitus (DM) that requires the high-risk medication insulin in order to maintain blood sugar control. The prevalence of insulin-related medication errors leading to hyper- and hypoglycemic reactions persists despite numerous interventions focused on provider prescriptive practice.
Purpose: This project provides evidence-based education to a cohort of new graduate nurses to increase nursing knowledge of safe insulin administration as well as raise awareness of comprehensive diabetes care.
Methods: The Iowa Model Revised guided this project through implementation of a live educational session provided through a video conference …
A Community-Based Education On Cardiovascular Diseases Among Vietnamese Buddhist Nuns, Uyen N. Nguyen
A Community-Based Education On Cardiovascular Diseases Among Vietnamese Buddhist Nuns, Uyen N. Nguyen
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: According to the World Health Organization, cardiovascular diseases (CVDs) are the leading cause of death (31%) worldwide. Out of those cases, 85% are due to heart attack and stroke. Hypertension is among the most modifiable risk factors for the development of cardiovascular diseases. Since Vietnamese Buddhist nuns have diets high in salt, this makes them at higher risk for hypertension and CVDs.
Purpose: This educational project aims to improve cardiovascular health knowledge among Vietnamese Buddhist nuns in the greater Seattle area by implementing culturally tailored community-based health education programs virtually via phone.
Methods: A community-based educational …
Implementation Of An Evidence-Based Screening Tool For Children For Detection Of Developmental, Behavioral And Family Issues, Lyndsay Goss
Implementation Of An Evidence-Based Screening Tool For Children For Detection Of Developmental, Behavioral And Family Issues, Lyndsay Goss
Doctor of Nursing Practice (DNP) Projects
Background: Children are a vulnerable population who are at risk for a variety of developmental, behavioral and family concerns. Early intervention leads to improved outcomes. By implementing the comprehensive evidence-based screening tool the Survey of Well-being for Young Children (SWYC), within a Federally Qualified Health Center (FQHC), outcomes for these children may be improved through early intervention.
Methods: The SWYC survey was provided to parents and guardians of children ages zero to five years at one pilot site at a FQHC in New England during well child visits (WCV) over a 6-week period. Implementation success was measured through review …
Robot Pets In Dementia Care: An Educational Intervention, Laura Bradford
Robot Pets In Dementia Care: An Educational Intervention, Laura Bradford
Doctor of Nursing Practice (DNP) Projects
Background and Review of Literature: Dementia is a progressive disease of memory and functioning that affects almost six million people in the United States. Elders with dementia often experience depression, as well as behaviors such as agitation or wandering. Antipsychotic medications have been used to manage behaviors in dementia, but these medications can have serious side effects. There is data on effective non-pharmaceutical approaches to behavior management in dementia, but these techniques are not always used. The use of robot pets is a potential intervention, but there are currently no programs that include training about robot pets in dementia care. …
Evaluating The Impact Of An Educational Program On The Healthcare Providers Knowledge On Depression And Screening Among Adolescents And Young Adults, Albert Peprah
Doctor of Nursing Practice (DNP) Projects
No abstract provided.
Enabling Patients In Opioid Detox To Pursue Long-Term Recovery, Duny Damas
Enabling Patients In Opioid Detox To Pursue Long-Term Recovery, Duny Damas
Doctor of Nursing Practice (DNP) Projects
Background/Purpose: High readmission rates of individuals in need of opioid detoxification demonstrate that opioid detoxification alone may be insufficient to promote changes in behavior and prevent relapse. There is a critical need for improvement in treatment approaches along with efforts from healthcare professionals to lead opioid-dependent patients toward long-term recovery. Such a care improvement is feasible through the delivery of adequate education to providers regarding patients suffering from opioid addiction to facilitate a change in attitude and more effective treatment. Methods: Data collected through a pre-test survey assessed provider’s knowledge about opioid use disorder, the availability of screening …