Digital Commons Network^™

The Role Of The Nurse Practitioner In The Patient-Centered Medical Home, Patricia M. Sohn

Dissertations

The Patient Centered Medical Home (PCMH) was established to improve patient access to high quality, cost-effective primary care. Critical to this new model of care is the optimal utilization of nurse practitioners (NPs) in performing services traditionally offered by physicians. This study compared the roles of NPs and physicians in providing primary care in two PCMHs in a local health care system. During the calendar year 2011, a total of 50,471 patient visits occurred in the two PCMHs. Each PCMH consisted of a Traditional Clinic that saw patients on a scheduled basis and a Convenient Care Clinic that accepted walk-in …

The Feasibility Of An Advanced Practice Registered Nurse-Managed Adhd Resource Center In Missouri, Kara Janelle Stackley

Dissertations

The primary objective of this project was to develop a survey to determine provider receptiveness to referring patients to an advanced practice registered nurse-(APRN) managed center for the diagnosis and management of Attention Deficit/Hyperactivity Disorder (ADHD). A secondary aim of this project was to develop a business plan for the center, provided feedback from the survey was determined to be supportive. Physicians were more likely to use ADHD clinical guidelines (65%) in their practice and expressed greater comfort managing ADHD. Only 50% of APRNs use the clinical practice guidelines and 50% reported they were uncomfortable diagnosing and managing ADHD. Almost …

Identification And Management Of Vertebral Column Fractures In Primary Care, Christopher Richard Hemmer

Dissertations

The purpose of this project is to perform a program evaluation of current treatment patterns of primary care providers for osteoporotic vertebral compression fractures (VCF). VCF’s result in significant morbidity and long term sequelae following a VCF is not uncommon. Additionally, there is controversy regarding the diagnosis and management of this disorder, especially as these relate to the clinical practice guidelines. This practice evaluation project included a pre and post-test survey and a continuing education offering. Thirty-nine physicians and nurse practitioners completed the survey instruments and attended the continuing education sessions. The educational session resulted in improvement of the provider’s …

Recognition Of Compassion Fatigue Among Medical-Surgical Nurses: The Provision Of Education To Manage The Effects, Kandace Woodruff

Doctor of Nursing Practice (DNP) Projects

The Institute of Medicine (IOM) (2010) recommends that healthcare organizations make the “recruitment and retention of qualified nurses a priority”. The ability to comply with the recommendation is fraught with challenges. Nurses are required to care for patients across the age span with varying medical complexities. There are work related stressors which are inherent to the care of a more acutely ill patient population. The tenuousness produced by this type of environment can predispose the nurse to a stress induced phenomenon known as, Compassion Fatigue. The literature is abounding with information related to compassion fatigue among various nursing specialties. However, …

Text Messaging As Adjunct To Community Based Weight Management Program, Claudia Bouhaidar

Theses and Dissertations

Obesity ascending rates are still a public health priority. The primary aim of the study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pre and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support and physical activity were assessed at baseline and at 12 …

A Gap Analysis Of Nursing Systems And Practices In Malaysia: Culturally Appropriate Interventions To Advance Nursing, Chenit Ong-Flaherty

Doctor of Nursing Practice (DNP) Projects

This project comprises a gap analysis of differences between American and Malaysian nursing programs, and additionally, proposes culturally appropriate interventions for Malaysian nursing to adopt American nursing models. The gap analysis was conducted on nursing systems and practices in Malaysia undertaken to identify the differences between Malaysian and American nursing, and the influences that affect Malaysian nursing. The aim is to facilitate the use of the American Nurses Credentialing Center (ANCC) Pathway to Excellence Practice Standard #4: Orientation Prepares New Nurses for the Work Environment, and #6: Professional Development is Provided and Used. The proposal of culturally appropriate interventions as …

The Lived Experience Of Fathers Whose Children Are Diagnosed With A Genetic Disorder, Mary T. Rivard

Nursing Theses and Dissertations

Parenting a child with a genetic disorder requires overcoming numerous obstacles. The purpose of this study was to understand the experience of fathers whose children have been diagnosed with a genetic disorder. By gaining insight into a father's reactions and needs, nurses will be better able to provide anticipatory guidance, emotional support, assistance with stressor identification, development of coping mechanisms, and problem solving strategies to assist him in coping with his child's condition.

Exploring The Differences Between Adult Cancer Survivors And Their Caregivers' Social Support, Self-Efficacy For Physical Activity, Physical Activity Behavior, And Quality Of Life, Fedricker Diane Barber

Nursing Theses and Dissertations

Less than 20% of cancer survivors meet recommended physical activity (PA) guidelines. Research reporting positive impact of social support on PA in cancer survivors has not included their caregivers' PA. A review of the literature examining social support and PA in cancer survivors supported including caregivers in developing strategies to increase PA in cancer survivors. The purposes of this study were: (1) to explore the differences and relationships between adult cancer survivors' and caregivers' social support, self-efficacy for physical activity (SEPA), PA, and quality of life (QOL), and (2) understand cancer survivors and caregivers' perception of social support in PA …

Vulnerability And Adaptation For Traumatic Brain Injury Survivors, Amy Johnson

Nursing Theses and Dissertations

Many of the over 5 million survivors of traumatic brain injury (TBI) with related disabilities living in the community do not have support for their unmet needs. Adapting to life after TBI is difficult because of cognitive, emotional, and behavioral complications. Nurses and other healthcare professionals have the opportunity to promote positive outcomes for persons with TBI. However, to increase the depth and breadth of that support, nurses need a base of knowledge that includes an understanding of the TBI survivors' needs, vulnerabilities, and obstacles to adaptation. TBIs result in physical, psychological, developmental, and emotional losses. The needs that ensue …

Effect Of Telephone Counseling On Physical Activity Among Older Adult Cancer Survivors, Ellen C. Mullen

Nursing Theses and Dissertations

The elderly population, especially those with cancer coupled with low health literacy, is at high risk for poor health outcomes. Telephone counseling has been shown to be effective in improving health behaviors among other populations, but it has not been studied for older adult cancer survivors. The purpose of this mixed methods study was to examine the effectiveness of telephone counseling on physical activity among older adult cancer survivors (n=50). The relationship between health literacy level and perceived changes in physical activity was assessed. Based on existing literature and Orem's Theory of Self-care, the following hypotheses were tested: H1: Telephone …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

• Greetings
• Pacesetter Grads Feel Boost in Entry to Nursing Workforce
• UTHealth-UH Dual Bachelors Program for First-Time Students
• UTHealth School of Nursing – By the Numbers
• 2012 PARTNERS Spring Luncheon – honored “Generations of Nurses” – guest speaker Naomi Judd
• UT Health Services Expands Care for Patients
• When I Grow Up, – A UTHealth Nursing Student’s Story
• Donors Support Start of New Accelerated Family Nurse Practitioner Program
• Giuseppe Colasurdo, M.D. – Appointed Sixth President in U THealth’s 40-Year History
• Dean Starck Named to UT Academy of Health Science Education, Marcus Honored by Regents for Outstanding Teaching
• Students Select Two for 2012 …

Non-Invasive Positive Pressure Ventilation (Nppv) Its Uses, Complications, & Implications Within Nursing Practice In Acute Care Settings, Alexis Marano

HIM 1990-2015

The use of noninvasive positive pressure ventilation (NPPV) in acute care settings has drastically increased within the past 20 years. Research has indicated that NPPV is equally as effective as traditional mechanical ventilation(MV) in treating acute exacerbations of chronic pulmonary obstructive disease (COPD) and cardiogenic pulmonary edema. Furthermore, the risk of complication from NPPV is much lower than MV, in terms of ventilator-associated pneumonia and sepsis. It is imperative for the nurse to understand the various indications, interfaces, and potential complications associated with NPPV use. In addition to treating acute exacerbations of COPD and cardiogenic pulmonary edema, NPPV has been …

Literature Review Examining Continuous Subcutaneous Insulin Infusion And Effects On Hemoglobin A1c, Hypoglycemia, Hyperglycemia/Diabetic Ketoacidosis, And Quality Of Life, Jamie Moses

Graduate Research Projects

No abstract provided.

Continuing Professional Development Program On Second-Generation Antipsychotics For Psychiatric-Mental Health Staff Nurses, Brenda Lee Phillips

Doctoral Projects

The lack of continuous professional development education regarding second-generation antipsychotics (SGAs) at a regional state acute care psychiatric hospital limits the ability of psychiatric-mental health (PMH) staff nurses to provide care for patients with or at risk for metabolic syndrome and other medical problems. The goals of the evidence-based program were to (1) examine PMH staff nurses’ knowledge of treatment guidelines for schizophrenia and SGAs; (2) provide education on schizophrenia, SGAs, and metabolic syndrome; and (3) provide continuous professional development training modules on schizophrenia and SGAs electronically for PMH staff nurses in an acute care mental health hospital. The effectiveness …

Identification And Prevention Of Secondary Traumatic Stress In Mental Health Professionals Who Work With Child Sexual Abuse Victims, Abby Duckworth Mcneil

Doctoral Projects

Secondary traumatic stress (STS) is an issue that may be experienced by mental health professionals who are exposed to clients' trauma materials and become and become at risk of becoming traumatized themselves. Mental health professionals working with sexually abused children are more vulnerable to STS due to their empathic engagement and level of exposure to trauma. The impact of STS can result in poor productivity, increase in illness, and turnover rates for mental health professionals. Cumulative effects of STS make awareness and early intervention imperative. Research has shown that members of the helping profession suffer emotional and physical illness more …

Value Based Purchasing: Positioning A Healthcare Organization For The Future, James Dale Heard

Doctoral Projects

In 2005, the Deficit Reduction Act introduced Value Based Purchasing (VBP) into the healthcare system as a means of hospital reimbursement for acute care hospitals receiving reimbursements from the Centers of Medicare and Medicaid (CMS). The purpose of this Capstone Project was to increase the knowledge of healthcare executives concerning Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and VBP and the effect it will place on the organization though the utilization of a consultant program. The role of the consultant in this project is to provide expert advice to healthcare executives about the impacts of HCAHPS and provide …

Exploration Of Self-Care Following Distribution Of Acute Management Tool For Elder Heart Failure Patients In Clinic Setting, Sharon Elaine Vincent

Doctoral Projects

The aim of this study was to develop a broad understanding of heart failure patients’ perceptions about their lived experiences. An acute symptom management tool, Red Flags I Need to Know: Heart Failure Action Plan (Health Net Federal Services, 2011), was distributed to the patients prior to initiation of the project.

The problem of heart failure rehospitalization is significant. Cost of treatment for heart disease in the United States exceeds all other conditions. The national excessive 30-day readmission rate in elders post-discharge is 24.8%. Pay-for-performance initiatives will reduce reimbursement for excessive readmissions beginning FY 2013.

The project was a mixed …

Impact Of Social Marketing On Nurse Practitioners' Acceptance Of Clinical Video Telehealth For Elderly Patients In Rural Mississippi, Teresa Lynn Langley

Doctoral Projects

Elderly patients 65 years and older who have chronic illness and disabilities living in rural Mississippi have increased difficulty in obtaining timely cost-effective healthcare services from nurse practitioners. The purpose of the capstone project was to utilize social marketing strategies for promoting nurse practitioners’ acceptance of clinical video telehealth (CVT) in improving healthcare access for rural elderly patients in Mississippi. Clinical video telehealth is an innovative way to provide healthcare services to populations in need by reducing barriers to healthcare, such as distances, time, and transportation, and financial resources. However, providing healthcare through the use of technology has not always …

Media Created Violence: A Social Determinant Of Mental Health., Shamshad Begum, Shaneela Sadruddin Khowaja, Gulnar Ali

School of Nursing & Midwifery

In today's high technological world, scientific discoveries contribute remarkable development to human life, but it could also have an adverse impact on mankind. Among all these advancements, media is one of the inventions which aims at capturing a countless group of viewers and transmit information via various mediums. Media violence is considered one of the hampering determinants which harms an individual psychologically. The primary goal of a health professional is to work for the maintenance of mental health. Therefore, it is imperative to create an understanding about the impact of media violence on mental health, particularly in the Pakistani context. …

Pepsin And Salivary Amylase Biomarkers Of Microaspiration In Oral And Tracheal Secretions Of Intubated Patients, Aurea Middleton

HIM 1990-2015

Introduction: The presence of an endotracheal tube (ETT) increases the risk for microaspiration of secretions around the ETT. Biomarkers of pepsin and salivary amylase may be used to identify microaspiration in intubated patients because of their naturally occurring presence in the stomach or oral cavity and non-occurrence in the respiratory tract. Microaspiration may be difficult to detect until pulmonary complications, such as lung injury or infection, occur. This study assessed the presence of pepsin and salivary amylase in oral and tracheal secretions of ventilated adults. Method(s): This is a secondary analysis of data collected from 11 critically ill, adult patients …

Understanding And Treating Smoking Among Individuals With A Mental Illness, Chizimuzo T.C. Okoli

Nursing Presentations

• Background and significance

• Reasons for smoking among individuals living with a mental illness

• Smoking cessation treatment for individuals living with a mental illness

Pepsin And Amylase In Oral And Tracheal Secretions Of Patients With Standard Versus Continuous Subglottic Suctioning Endotracheal Tubes, Katherine Allen

HIM 1990-2015

The aspiration of oral and gastric substances is a well-known risk for ventilator associated pneumonia (VAP) in the intubated, mechanically ventilated (MV), patient of the intensive care unit (ICU) population. The gastric biomarker pepsin and the oral biomarker salivary amylase have been identified as evidence of aspiration prior to the manifestation of acute pulmonary illness. In an effort to decrease the risk for aspiration, several evidence based nursing practices are in place. Actions include 30 degree head of the bed positioning, oral care, suctioning, and circuit change interval protocols, as well as the administration of medication with the objective of …

The Meaning Of The Lived Experience Of Nursing Faculty On A Dedicated Education Unit, Deborah Ann Demeester

UNLV Theses, Dissertations, Professional Papers, and Capstones

In 2011, 58,327 qualified applicants were denied admission to U.S. baccalaureate programs due to an inadequate number of qualified faculty, insufficient clinical placement sites, and resource constraints. Nursing faculty leaders are being challenged to increase enrollment to address a projected worsening nursing shortage and to transform prelicensure nursing education to ensure that program graduates have the nursing skills and competencies to meet the health care needs of the population.

Collaborative educational partnerships offer promising strategies to diminish the nursing faculty shortage, educate more students, and provide stable, rich learning environments. The Dedicated Education Unit (DEU) model is one of these …

Successful Aging In Hispanic Elders: A Narrative Inquiry, Julie Kay Carr

Boise State University Theses and Dissertations

Purpose: The purpose of this narrative study was to describe and provide an understanding of the unique cultural factors that are associated with successful aging in the elder Hispanic population.

Background: The number of aging Hispanic in Americans is on the rise. The Center for Disease Control recently released data showing the life expectancy for the Hispanic population is 80.6 years — a 2.5 year advantage over the non-Hispanic white population and 7.7 years over the non-Hispanic black population. With longer life spans resulting in an increased number of Hispanic older adults, we are presented with a difference that – …

Nurses’ Perceptions Of The Support Needs Of Women Experiencing A Crisis Pregnancy, Kristyn Dyson

Boise State University Theses and Dissertations

Background: In the United States, one half of all pregnancies are unintended. Research suggests that many women make a decision about their pregnancy immediately, taking action very quickly without any form of options counseling. Women oftentimes do not conceptualize their pregnancy as a scenario involving three alternative outcomes. Research has shown that when in a state of crisis, the decision-making process is diminished and the individual becomes vulnerable. Additionally, when making decisions in the absence of adequate social support, negative health outcomes can result.

Objectives: To explore nurses’ perceptions of the social support needs of women experiencing a crisis …

Predictors Of Drug Court Client Graduation, Marie E. Gill

Theses and Dissertations (ETD)

Background: Substance use disorder in the United States adversely effects society by burdening the justice system with offender incarceration for drug-related crimes, it also strains in the healthcare system with costs in excess of $216 billion dollars for treatment of drug-related mental and physical illnesses. Many offenders of nonviolent crimes with substance use disorder have been diverted to Drug Court (DC) for year-long supervised community-based drug addiction treatment as an alternative to incarceration for non-violent drug-related crimes. Drug Court program outcomes, however, have been studied as a criminal justice intervention, rather than a primary care mental health intervention. The majority …

Living In Harmony: Health Perspectives Of Hispanics In Rural East Tennessee., Erin E. Bailey

Undergraduate Honors Theses

The purpose is to promote culturally competent care among healthcare providers by identifying and describing how Hispanics in East Tennessee view health and what they do to prevent illness. A focus group of six to ten Hispanics of mixed genders over age eighteen moderated by a native Spanish-speaking interpreter. Questions explored how Hispanics define health and sickness, health maintenance practices, and alternative medicines and practices. Results were interpreted from Spanish to English to be analyzed. The Circle in Which You Live was described by members as consisting of relationships, physical health, and peace of the mind and soul. In Shutting …

Exploring Healthcare Simulation As A Platform For Interprofessional Education, Janice Christine Palaganas

Loma Linda University Electronic Theses, Dissertations & Projects

Interprofessional education (IPE) is gradually recognized as essential to patient safety and implemented as a standard for healthcare education through professional organization recommendations and accrediting bodies. Given the increasing adoption of experiential and team-based learning, healthcare simulation (HCS) has become a preferred vehicle for IPE. As healthcare professional educators explore simulation as a platform for IPE, a need to better understand the state of the science has become apparent. This descriptive comparative study examines how the most commonly used simulation modalities and IPE teaching methods (low-technology versus high-technology; multiprofessional versus collaborative team-based activities; observational versus active methods; standardized patients versus …

Immersion Research Education: Students As Catalysts For International Collaboration Research, Kathryn H. Anderson, Marie-Luise Friedemann, Andreas Buescher, Julita Sansoni, Donna R. Hodnicki

Nursing: Faculty Publications

Background:  This paper describes an international nursing and health research immersion program. Minority students from the USA work with an international faculty mentor in teams conducting collaborative research. The Minority Health International Research Training (MHIRT) program students become catalysts in the conduct of cross-cultural research.

Aim:  To narrow the healthcare gap for disadvantaged families in the USA and partner countries.

Methods:  Faculty from the USA, Germany, Italy, Colombia, England, Austria and Thailand formed an international research and education team to explore and compare family health issues, disparities in chronic illness care, social inequities and healthcare solutions. USA …

Expectations And Experiences Of Fathers Who Have Parented Children With And Without Intellectual Disabilities, Jane Christina Kusmik Walker

Electronic Theses and Dissertations

The parenting experience is as diverse as the children parented. Each child has diverse personality traits requiring flexibility and specificity in parenting strategy. This need for flexibility and specificity is more complex when one or more children within a family has an intellectual disability. Although research in this area is abundant, investigators have historically focused on mothers' attitudes, beliefs, and behaviors to represent the entire family (Essex, Seltzer, & Krauss, 2001; Greenberg, 2002) rather than focusing on fathers and their caregiving relationships with their children in need of malleable but consistent parenting. Using a qualitative descriptive design, this qualitative study …